CAJ | 학술논문

目的观察联合促性腺激素释放激素激动剂(GnRH-a)与放置左炔诺孕酮官内缓释系统(LNG-IUS)治疗明显增大子宫腺肌病的临床效果.方法 12例子宫腺肌病患者,(测官腔长度≥11 cm,平均年龄40.3岁).接受皮下注射戈舍瑞林3.6 mg,每4周1次,至测量官腔深度≤10 cm时,放置LNG-1US12个月.在用GnRH-a治疗前、放置LNG-IUS后6个月、放置LNG-IUS后12个月进行疼痛VAS评分和月经量PBAC评分,并检测相应子宫体积和血红蛋白变化.结果疼痛VAS评分在GnRH-a治疗前68.3±9.3,放置LNG-IUS后6个月和12个月下降为22.2±8.3和6.8±4.2,之间差异有统计学意义(P<0.05).月经量PBAC评分在GnRH-a治疗前为153.8±21.6,放置LNG-IUS后6个月和12个月减少为39.2±12.3和16.7±5.2,之间差异有统计学意义(P<0.05).子宫体积在GnRH-a治疗前为(378.5±39.2)cm3,放置LNG-IUS时为(162.4±49.2) cm3,放置LNG-IUS后6个月和12个月子宫体积分别为(254.3±52.4)和(282.9±56.3) cm3;与GnRH-a治疗前比较,放置LNG-IUS时和放置LNG-IUS后6个月、12个月子宫体积显著缩小(P<0.05);而放置LNG-IUS后6个月较放置LNG-IUS时增大,差异有统计学意义(P<0.05).血红蛋白于GnRH-a治疗前为(92.6±8.2)g/L,放置LNG-IUS时、放置LNG-IUS后6个月和12个月分别为(113.1±5.2)、(116.5±4.5)、(120.3±4.1) g/L,均较GnRH-a治疗前显著上升,P<0.05.结论联合GnRH-a与LNG-IUS可有效治疗大子宫腺肌病合并疼痛与月经过多.
목적 관찰연합촉성선격소석방격소격동제(GnRH-a)여방치좌결낙잉동관내완석계통(LNG-IUS)치료명현증대자궁선기병적림상효과.방법 12례자궁선기병환자,(측관강장도≥11 cm,평균년령40.3세).접수피하주사과사서림3.6 mg,매4주1차,지측량관강심도≤10 cm시,방치LNG-1US12개월.재용GnRH-a치료전、방치LNG-IUS후6개월、방치LNG-IUS후12개월진행동통VAS평분화월경량PBAC평분,병검측상응자궁체적화혈홍단백변화.결과동통VAS평분재GnRH-a치료전68.3±9.3,방치LNG-IUS후6개월화12개월하강위22.2±8.3화6.8±4.2,지간차이유통계학의의(P<0.05).월경량PBAC평분재GnRH-a치료전위153.8±21.6,방치LNG-IUS후6개월화12개월감소위39.2±12.3화16.7±5.2,지간차이유통계학의의(P<0.05).자궁체적재GnRH-a치료전위(378.5±39.2)cm3,방치LNG-IUS시위(162.4±49.2) cm3,방치LNG-IUS후6개월화12개월자궁체적분별위(254.3±52.4)화(282.9±56.3) cm3;여GnRH-a치료전비교,방치LNG-IUS시화방치LNG-IUS후6개월、12개월자궁체적현저축소(P<0.05);이방치LNG-IUS후6개월교방치LNG-IUS시증대,차이유통계학의의(P<0.05).혈홍단백우GnRH-a치료전위(92.6±8.2)g/L,방치LNG-IUS시、방치LNG-IUS후6개월화12개월분별위(113.1±5.2)、(116.5±4.5)、(120.3±4.1) g/L,균교GnRH-a치료전현저상승,P<0.05.결론연합GnRH-a여LNG-IUS가유효치료대자궁선기병합병동통여월경과다.
Objective To evaluate the effects of levonorgestrel-releasing intrauterine system (LNG-IUS) combined with GnRH analogue (GnRH-a) in the treatment of adenomynsis with uterine body enlargement. Methods Twelve women (mane age 40.3 years) with adenomyosis and uterine cavity depth over 11 cm received injections of GnRH-a every 4 weeks, and after the uterine cavity depth was reduced to below 10 cm, LNG-IUS was deployed. VAS pain score, PBAC bleeding score, uterine volume, and hemoglobin levels of the women were measured before the treatment and at 6 and 12 months after LNG-IUS placement. Results The VAS pain score was significantly lowered at 6 and 12 month after LNG-IUS placement (P<0.05), and the PBAC bleeding score also showed significant reductions (P<0.05). The uterine volume decreased significantly at 6 and 12 months after LNG-IUS placement as compared with that before the treatment, but was significantly greater at 6 month in comparison with that at the time of LNG-IUS placement (P<0.05). Serum hemoglobin levels underwent significant increments after LNG-IUS placement (P<0.05). Conclusion LNG-IUS combined with GnRH analogue injeetien can be effective in the treatment of adenomyosis with dysmenorrhea and hypermenorrhea.