摘要
目的 探讨卵巢子宫内膜异位症患者腹腔镜下保守性手术后应用左炔诺孕酮宫内缓释系统（LNG-IUS）的作用.方法 对150例行腹腔镜下保守性手术的卵巢子宫内膜异位症患者（研究组）,术后放置LNG-IUS,随访其疗效和不良反应.并选择同期行腹腔镜下保守性手术治疗的卵巢子宫内膜异位症患者50例为对照组,术后仅接受孕三烯酮短暂治疗,随访比较两组的复发率.结果 研究组放置后3、6、12个月,子宫内膜厚度逐渐变薄[（6.02±1.84）、（5.68±1.38）、（4.04±1.24） mm比（7.85±1.62） mm],月经量和痛经疼痛视觉模拟量表（VAS）评分逐渐下降[（48.29±7.04）、（32.64±6.09）、（19.74±4.78）ml比（65.63±7.83）ml,（35.74±16.34）、（20.54±12.29）、（13.79±10.38）分比（78.13±15.69）分],与放置前比较差异均有统计学意义（P＜0.05）;放置后3个月,月经期[（9.42±3.75）d]较放置前[（6.69±2.83）d]明显延长,放置后12个月[（4.53±1.37）d]较放置前明显缩短,差异均有统计学意义（P＜0.05）;各时间点月经周期比较差异无统计学意义（P＞0.05）.随访期间,研究组LNG-IUS不良反应以月经间期出血为主,但随着使用时间延长其发生率逐渐降低,差异有统计学意义（P＜0.05）;其他不良反应均少见,且部分也逐渐降低.术后12个月,研究组复发率明显低于对照组[14.7％（22/150）比30.0％（15/50）],差异有统计学意义（P＜0.05）.结论 LNGIUS可以有效改善卵巢子宫内膜异位症患者腹腔镜下保守性手术后的症状和体征,并可在一定程度上预防保守性手术后残余病灶的复发.
Objective To discuss the effect of levonorgestrel-releasing intrauterine system （LNG-IUS） in ovarian endometriosis after laparoscopic operation.Methods One hundred and fifty patients with ovarian endometriosis were treated by placement of LNG-IUS after laparoscopic operation （study group）.The therapeutic effect and adverse reaction were observed.Fifty patients with ovarian endometriosis only treated by orally gestrinone were as control group.The rate of recurrence was compared.Results After placement of LNG-IUS for 3,6,12 months,the thickness of endometrium in study group was significantly thinner [（6.02 ± 1.84）,（5.68 ± 1.38）,（4.04 ± 1.24） mm vs.（7.85 ± 1.62） mm],the amount of menorrhea and the scores of visual analogue scale （VAS） was significantly decreased [（48.29 ± 7.04）,（32.64 ± 6.09）,（19.74 ± 4.78） ml vs.（65.63 ± 7.83） ml,（35.74 ± 16.34）,（20.54 ± 12.29）,（13.79 ± 10.38） scores vs.（78.13 ± 15.69） scores],there was significantly difference compared with that before treatment （P ＜ 0.05）.After placement of LNG-IUS for 3 months,the menstrual period in study group was significandy longer than that before treatment [（9.42 ± 3.75） d vs.（6.69 ± 2.83） d],and after placement of LNG-IUS for 12 months,the menstrual period in study group [（4.53 ± 1.37） d] was significantly shorter than that before eatment （P ＜ 0.05）.In study group,the menstrual cycle had no significant difference among different time point （P ＞0.05）.In follow-up period,the adverse reaction in study group was mainly intermenstrual bleeding,and the rate of intermenstrual bleeding was gradually decreased （P ＜ 0.05）.Others adverse reaction was rare,and the incidence rate was gradually decreased.The rate of recurrence in study group was significandy lower than that in control group [14.7％（22/150） vs.30.0％（15/50）]（P＜0.05）.Conclusion Placement of LNG-IUS after laparoscopic operation can reduce symptoms and signs,and can play important role in preventing recurrence.
出处
《中国医师进修杂志》
2013年第33期7-9,共3页
Chinese Journal of Postgraduates of Medicine
