【摘要】 目的观察并比较左炔诺孕酮宫内释放系统(LNG-IUS,商品名曼月乐)和促性腺激素释放激素激动剂(GnRHa,商品名达菲林)方案治疗子宫腺肌病的效果。方法将40例子宫腺肌病患者随机分为曼月乐组与达菲林组,各20例。曼月乐组于月经周期第3～7天由专人宫内放置曼月乐,达菲林组在月经第1天注射达菲林,此后每隔28 d注射1次。观察两组治疗后痛经情况、月经量、子宫体积、子宫内膜厚度的变化,检测血清CA125水平。以后3个指标评价疗效。结果与治疗前相比,两组治疗后VAS改善、月经量明显减少(P均<0.05),血清CA125水平无明显变化(P均>0.05)。与治疗前比较,治疗后6个月曼月乐组子宫体积变化不明显(P>0.05),子宫内膜厚度明显变薄(P<0.05);达菲林组子宫体积变小(P<0.05),子宫内膜厚度改变不明显(P>0.05)。两组治疗后6个月子宫体积及血清CA125相比,P均<0.05。曼月乐组有效17例,无效3例,有效率为85%;达菲林组分别为18、2例和90%,两组有效率相比,P>0.05。两组同期(治疗6个月)治疗费用分别为1 330、11 184元,两组相比,P<0.01。结论 LNG-IUS方案与GnRHa方案治疗子宫腺肌病疗效相近,但曼月乐较达菲林更为经济。更多还原

【Abstract】 Objective To compare efficacy of the levonorgestrel-releasing intrauterine system(LNG-IUS,Mirena) with GnRH analogue(GnRHa,Triptorelin Acetate) on adenomyosis.Methods Forty women with adenomyosis were treated with either LNG-IUS(n=20,LNG-IUS group) or GnRHa(n=20,GnRHa group).These patients with adenomyosis were followed up in 1,3,6 months after placing LNG-IUS.Score of dysmenorrhea,menstrual flow and uterine volume,endometrium thicknes,CA125 were compared.Results After treatment of LNG-IUS or GnRHa,dysmenorrhea were completely catabatic,themenstrual blood volume significantly reduced(all P<0.05),but CA125 didn’t change significantly(all P>0.05).And the size of uteri didn’t change significantly after LNG-IUS(all P>0.05).Patients with adenomyosis were followed up in 6 months after GnRHa,endometrium thicknes had no statistical significance.The size of uteri after GnRHa and endometrium thicknes after LNG-IUS were changed significantly(all P<0.05).The response rate was 85% in LNG-IUS group and 90% in GnRHa group(P>0.05).Six months of reatment costs in LNG-IUS group was less than GnRHa group(P<0.01).Conclusion The efficacy of LNG-IUS and GnRHa program in treatment of adenomyosis is similar,but the Mirena compared with Triptorelin Acetate is more economical.更多还原