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目的观察左炔诺孕酮宫内缓释系统治疗子宫内膜异位症的临床疗效及安全性。方法 51例患者在第1个月月经来潮后第2~5天,按照操作指南由专人行宫内放置LNG-IUS术(德国拜耳公司产品)。结果 24个月后,与放置LNG-IUS前相比,51例患者的痛经全部得到改善。痛经、性交痛、慢性盆腔痛评分显著下降,差异有统计学意义(P<0.05);子宫体积、盆腔囊肿体积、子宫内膜厚度、血CA125明显下降,差异有统计学意义(P<0.05);血红蛋白值显著升高,差异亦有统计学意义(P<0.01)。不良反应:出现痤疮7例,月经间期出血12例,全身肿胀2例,面部色素沉着2例,脱发1例。结论放置左炔诺孕酮宫内缓释系统可抑制子宫内膜增长,改善患者痛经、性交痛、慢性盆腔痛等临床症状,副作用少,对子宫内膜异位症安全、有效。
Objective To observe the clinical efficacy and safety of levonorgestrel-releasing intrauterine system in the treatment of endometriosis. Methods Fifty-one patients underwent LNG-IUS surgery (product of Bayer AG, Germany) by hand in the womb on the 2nd to 5th days after menstruation on the first month. Results After 24 months, dysmenorrhea was all improved in 51 patients compared to before LNG-IUS placement. Dysmenorrhea, painful intercourse and chronic pelvic pain were significantly decreased (P <0.05). The volume of uterus, the volume of pelvic cavity, the thickness of endometrium and the level of serum CA125 were significantly decreased (P <0.05) ; Hemoglobin value was significantly increased, the difference was also statistically significant (P <0.01). Adverse reactions: acne occurred in 7 cases, 12 cases of menstrual bleeding, systemic swelling in 2 cases, 2 cases of facial pigmentation, hair loss in 1 case. Conclusion The levonorgestrel-releasing intrauterine system can inhibit the growth of endometrium and improve the clinical symptoms and side effects of dysmenorrhea, sexual intercourse pain and chronic pelvic pain. It is safe and effective for endometriosis.