张凤娟

[摘要] 目的 观察左炔诺孕酮宫内缓释系统治疗子宫腺肌病痛经的临床效果。方法 选择我院2015年3月～2016年3月68例子宫腺肌病痛经患者，根据治疗方法分为观察组（36例）与对照组（32例），对照组以孕三烯酮进行治疗，观察组以左诀诺孕酮宫内缓释系统进行治疗，观察两组患者的子宫内膜厚度、子宫体积、痛经评分、月经经期时间、血红蛋白、血清CA125、激素水平以及临床疗效和不良反应。结果 观察组患者子宫内膜厚度以及子宫体积改善情况明显优于对照组（P<0.05）；观察组患者痛经评分、月经经期时间改善情况明显优于对照组（P<0.05）；两组血红蛋白较治疗前上升（P<0.05），并渐至正常水平，血清CA125水平治疗后明显下降（P<0.05），且观察组优于对照组。结论 以左炔诺孕酮宫内缓释系统对子宫腺肌病痛经进行治疗，能够使患者子宫内膜厚度以及子宫体积得到显著改善，改善痛经症状，安全性好。

[关键词] 左炔诺孕酮宫内缓释系统；子宫腺肌病；痛经；孕三烯酮

[中图分类号] R711.51 [文献标识码] A [文章编号] 2095-0616（2017）16-72-03

The effects of levonorgestrel-releasing intrauterine system on dysmenorrhea of patients with adenomyosis of the uterus

ZHANG Fengjuan

Maternal and Child Health Care Family Planning Service Center of Zhangdian District of Zibo City， Zibo 255043， China

[Abstract] Objective To observe the clinical effect of levonorgestrel-releasing intrauterine system on dysmenorrhea of patients with adenomyosis of the uterus. Methods From March 2015 to March 2016， 68 patients with adenomyosis of the uterus were selected. According to the treatment method， the patients were divided into observation group （36 cases） and the control group （32 cases）. The patients in control group were treated with trienone， and the patients in the observation group were treated with levonorgestrel-releasing intrauterine system. The endometrial thickness， uterine volume， dysmenorrhea score， menstrual cycle time， hemoglobin， serum CA125， hormone levels， and clinical efficacy and adverse reactions were observed in both groups. Results The endometrial thickness and the improvement of uterine volume in the observation group were significantly better than that in control group（P<0.05）. The improvement of pain score and menstrual cycle time in the observation group were significantly better than that in the control group（P<0.05）. The hemoglobin of two groups were ascending before treatment（P<0.05）， and the serum CA125 level was significantly decreased（P<0.05）， and the CA125 level in observation group was better than that in the control group. Conclusion The treatment of uterine adenomyosis was treated with levonorgestrel-releasing intrauterine system， which could improve the thickness of endometrium and the volume of uterus， improve the symptoms of dysmenorrhea， and improve the safety.

[Key words] Levonorgestrel-releasing intrauterine system； Adenomyosis of the uterus； Dysmenorrhea. gestrinone

子宮腺肌病是妇科常见的良性疾病之一，也称内在性子宫内膜异位症，该疾病是指子宫肌层内存在子宫内膜腺体和间质，良性入侵到子宫肌壁层。好发于30～50岁的妇女，目前发病率逐渐上升 [1-2]，其临床表现主要是月经异常，继发性痛经、月经量较多，甚至发生不孕不孕。而痛经（dysmenorrheal）是妇科常见疾病之一，是一种伴随月经的规律性发作疼痛症状，全世界女性经历过痛经占50%～80%，痛经随月经周期而发子宫痉挛性疼痛，常伴有坠胀、腰膝酸软、恶心、呕吐、头晕、乏力等症状，症状表现，重者伴有面色苍白、出冷汗，甚至剧痛晕厥[3]，生活、工作受到较大的影响[1]，长期痛经可能会引起女性心理问题。传统西医治疗多应用非甾体抗炎药、口服避孕药，疗效尚可，但长期应用存在部分患者不能耐受、不良反应大、镇痛疗效渐差等问题。……