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目的:探讨卵巢子宫内膜异位囊肿保守性手术后宫腔放置左炔诺孕酮宫内缓释系统(LNG-IUS)的临床价值。方法:选择2006年1月~2008年4月在我院施行卵巢子宫内膜异位囊肿剥除术患者90例,分为A、B、C 3组,A组31例(LNG-IUS组),B组30例(孕三烯酮组),C组29例(未用药组)。观察比较术前VAS>3分者治疗后VAS的评分变化,治疗6个月A、B两组FSH、LH和E2水平,治疗1年A、B两组患者对治疗效果满意度并愿继续接受治疗的情况以及治疗费用等。结果:A组治疗3个月和6个月VAS与术前比较有显著差异(P<0.01);与B组的差异无统计学意义(P=0.611,P=0.462);治疗1年A组与B组平均VAS评分无显著差异(P=0.623),A组与C组的差异有统计意义(P<0.05)。术后6个月A组E2平均水平正常为85.41±25.73 pmol/L;B组E2明显降低为53.80±16.64 pmol/L,与治疗前的差异有统计学意义(P<0.05)。治疗1年愿意继续治疗的A组占87%明显高于B组的47%,差异有统计学意义(P<0.01);而治疗费用两组无显著差异。结论:LNG-IUS治疗卵巢子宫内膜异位囊肿引起的疼痛有一定的作用,对卵巢功能影响较小,有较好的依从性,可作为卵巢子宫内膜异位囊肿保守手术后的辅助治疗方法。
Objective: To investigate the clinical value of intrauterine delivery of levonorgestrel-releasing intrauterine system (LNG-IUS) after conservative surgery of ovarian endometriotic cysts. Methods: Ninety patients with ovarian endometriosis were divided into three groups (A, B, C 3), group A (31 LNG-IUS) , 30 cases in group B (gestrinone group) and 29 cases in group C (non-medication group). The changes of VAS scores in VAS> 3 points before operation were observed and compared. The levels of FSH, LH and E2 in 6 months A and B groups were treated. The patients in A and B groups were satisfied with the treatment effect and would like to continue to accept the treatment Treatment and treatment costs. Results: The VAS in group A at 3 months and 6 months were significantly different from those before operation (P <0.01). There was no significant difference between group A and group B (P = 0.611, P = 0.462) There was no significant difference between group A and group C (P <0.05). There was no significant difference between group A and group C (P <0.05). The average level of E2 in group A was 85.41 ± 25.73 pmol / L at 6 months after operation, while E2 in group B was significantly decreased to 53.80 ± 16.64 pmol / L, which was significantly different from that before treatment (P <0.05). 87% in group A who were willing to continue treatment for 1 year was significantly higher than that in group B (47%), the difference was statistically significant (P <0.01); while the treatment cost was no significant difference between the two groups. CONCLUSION: LNG-IUS treatment of ovarian endometriosis-induced cyst pain has a certain effect, less effect on ovarian function, with better compliance, can be used as adjuvant conservative treatment of ovarian endometriosis after surgery method.