摘要
目的分析弥漫性大子宫腺肌病患者放置左炔诺孕酮宫内缓释系统(LNG-IUS,商品名:曼月乐)前应用促性腺激素释放激素激动剂(GnRH-a)皮下注射或口服米非司酮预处理对治疗效果的影响。方法选取2013年12月-2015年12月在河北医科大学第二医院接受LNG-IUS治疗的38例弥漫性大子宫腺肌病患者随机分为两组各19例,在放置LNG-IUS前一组给予注射GnRH-a 3个周期,一组给予米非司酮片4个周期预处理。随访患者置环后不同时间点的携带状态、痛经情况、疼痛评分、子宫出血评分,分析宫腔内放置LNG-IUS前应用GnRH-a或使用米非司酮预处理对于治疗弥漫性大子宫腺肌病效果的影响。结果GnRH-a预处理组患者的子宫体积在放置LNG-IUS后1个月和3个月比米非司酮预处理组患者的小,痛经评分、子宫出血评分在放置后3个月比米非司酮预处理组患者的低,差异均有统计学意义(P<0.05)。两组患者放置后任何时间点的子宫体积、痛经评分、子宫出血评分均小于放置前,差异有统计学意义(P<0.05)。结论弥漫性大子宫腺肌病患者放置曼月乐前使用GnRH-a预处理短期内临床治疗效果优于米非司酮,但长期效果相似。
Objective To analyze the effect of pretreatment with subcutaneous injection of gonadotropin-releasing hormone agonist(GnRH-a)or oral administration of mifepristone on curative effect of levonorgestrel intrauterine sustained release system(LNG-IUS,mirena)in patients with diffuse large adenomyosis.Methods Thirty-eight patients with diffuse large adenomyosis treated by LNG-IUS in the Second Hospital of Hebei Medical University from December 2013 to December 2015 were selected and randomly divided into two groups,19 patients in each group.Before application of LNG-IUS,the patients in one group were treated by injection of GnRH-a for three courses of treatment,and the patients in another group were treated by oral administration of mifepristone for four courses of treatment.The carrying statuses of IUS,dysmenorrheal scores,menstrual scores,and uterine hemorrhage scores after application of LNG-IUS at different time points were followed up.The effects of different pretreatments on curative effect of mirena in treatment of diffuse large adenomyosis were analyzed.Results Compared with mifepristone pretreatment group,uterine volumes of patients in GnRH-a pretreatment group at 1 and 3 months after application of LNG-IUS decreased,menstrual score and uterine hemorrhage score at 3 months after application of LNG-IUS decreased,there were statistically significant differences(P<0.05).In the two groups,uterine volumes,menstrual scores,and uterine hemorrhage scores at different time points after application of LNG-IUS were statistically significantly lower than those before application of LNG-IUS(P<0.05).Conclusion The curative effect of pretreatment with GnRH-a is better than that of mifepristone in patients with diffuse large adenomyosis treated by mirena,but the long-term effects are similar.
作者
杜洁贤
王康
田彩
张立星
李艳芳
DU Jie-Xian;WANG Kang;TIAN Cai(Department of Gynecology,the Second Hospital of Hebei Medical University,Shijiazhuang,Hebei 050000,China)
出处
《中国妇幼保健》
CAS
2020年第2期199-202,共4页
Maternal and Child Health Care of China
基金
河北省卫生计生委重点科技研究计划项目(20160519)
