CAJ | 학술논문

目的：观察宫腔镜子宫内膜切除( TCRE)联合左炔诺孕酮宫内缓释系统( LNG-IUS)治疗子宫腺肌病的临床疗效和可行性。方法收集2009年1月至2011年1月,我院收治62例无生育要求且预保留子宫的腺肌病患者,将其随机分为观察组和对照组,每组31例。对照组单纯放置LNG-IUS治疗,观察组给予TCRE联合LNG-IUS治疗。观察2组患者在LNG-IUS放置前及放置后1、3、6、12个月的月经量、疼痛视觉模拟( VAS)评分、子宫体积、血清CA125、生殖激素水平,记录2组不良反应发生情况。结果放置LNG-IUS后,2组患者月经过多症状均明显改善,CA125水平均明显降低,且观察组均显著优于对照组(P<0.05)；2组的VAS评分均明显降低,但组间无显著差异(P>0.05)。2组患者的子宫大小、血清FSH、LH、E2及P水平在放置LNG-IUS前后均未见明显改变,组间比较也未见显著差异(P>0.05)。结论 TCRE联合LNG-IUS治疗子宫腺肌病疗效显著,可以有效防止单纯放置LNG-IUS引起的淋漓出血,安全性好,是一种有效的保守治疗方法。
목적：관찰궁강경자궁내막절제( TCRE)연합좌결낙잉동궁내완석계통( LNG-IUS)치료자궁선기병적림상료효화가행성。방법수집2009년1월지2011년1월,아원수치62례무생육요구차예보류자궁적선기병환자,장기수궤분위관찰조화대조조,매조31례。대조조단순방치LNG-IUS치료,관찰조급여TCRE연합LNG-IUS치료。관찰2조환자재LNG-IUS방치전급방치후1、3、6、12개월적월경량、동통시각모의( VAS)평분、자궁체적、혈청CA125、생식격소수평,기록2조불량반응발생정황。결과방치LNG-IUS후,2조환자월경과다증상균명현개선,CA125수평균명현강저,차관찰조균현저우우대조조(P<0.05)；2조적VAS평분균명현강저,단조간무현저차이(P>0.05)。2조환자적자궁대소、혈청FSH、LH、E2급P수평재방치LNG-IUS전후균미견명현개변,조간비교야미견현저차이(P>0.05)。결론 TCRE연합LNG-IUS치료자궁선기병료효현저,가이유효방지단순방치LNG-IUS인기적림리출혈,안전성호,시일충유효적보수치료방법。
Objective To observe the effects of hysteroscopic transcervical resection of endometrium combined with levonorgestrel-relea-sing intrauterine system in the treatment of adenomyosis. Methods Clinical data of 62 cases with adenomyosis from January 2009 to January 2011 were randomly divided into 2 groups with 31 cases each. The observation group was given hysteroscopic transcervical resection of endo-metrium ( TCRE) combined with levonorgestrel-releasing intrauterine system( LNG-IUS) ,the control group was given LNG-IUS. All patients were followed up in 0,1,3,6,12 months after treatmenting with LNG-IUS. The menstrual blood volume,score of VAS,volume of uterus, CA125 and the levels of serum reproductive hormone were analyzed before treatment and after treatment. Results After the therapy,the cur-ative effects of controlling menorrhea were improved and the the observation group was significantly better than the control group(P<0. 05). The VAS scores were significantly decreased after the therapy in the two groups, but there was no significant difference between the two groups (P<0. 05). The level of CA125 in the observation group was significantly lower than the pretherapy,which was better than that in the control group (P<0. 05). There was no significant difference between the two groups in the volume of uterus after treatment and the levels of serum FSH,LH,E2 and P(P>0. 05). Conclusion It is exact effect to treat adenomyosis by TCRE combined with LNG-IUS,which can prevent dripping bleeding induced by application of LNG-IUS effectively.