国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2013, Vol. 32 ›› Issue (4): 244-246.

• 论著 • 上一篇    下一篇

左炔诺孕酮宫内缓释系统与子宫内膜电切术治疗月经过多的临床对照研究

王 玉 ,毕芳芳, 杨 清, 张淑兰   

  1. 110004 沈阳，中国医科大学附属盛京医院妇产科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2013-07-15 发布日期:2013-07-15

Application of the Levonorgestrel-releasing Intrauterine System and the Transcervical Endometrium Resection in Treating Menorrhagia: A Clinical Control Study

WANG Yu，BI Fang-fang，YANG Qing，ZHANG Shu-lan   

  1. Department of Obstetrics and Gynecology，China Medical University Affiliated Shengjing Hospital，Shenyang 110004，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2013-07-15 Online:2013-07-15

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摘要： 目的：比较左炔诺孕酮宫内缓释系统（LNG-IUS）与子宫内膜电切术治疗月经过多的疗效、不良反应和转归等情况。方法：采用前瞻性的研究方法，因月经过多就诊的96例患者，根据患者意愿分为2组，分别进行宫内放置LNG-IUS及宫腔镜下子宫内膜切除术（TCRE）治疗，其中LNG-IUS组46例，TCRE组50例。观察治疗后月经量、血红蛋白、不良反应等情况。结果：2种治疗方法均可有效减少月经量，TCRE组更优于LNG-IUS组（P＜0.05）。2组血红蛋白改善差异无统计学意义（P＞0.05），且均无严重并发症发生。LNG-IUS组的不良反应发生率（69.6%）高于TCRE组（14%），差异有统计学意义（P＜0.05）。结论：宫内放置LNG-IUS及TCRE均能有效治疗无器质性子宫病变的月经过多，改善贫血。LNG-IUS适合于要求保留生育功能的年轻患者，而TCRE更适合不要求保留生育功能者。

关键词: 迟效制剂, 宫内避孕器, 含药, 左炔诺孕酮, 电外科手术, 宫腔镜检查, 子宫内膜, 月经过多

Abstract: Objective：To compare the effectiveness，side effects and clinical outcomes of the levonorgestrel-releasing intrauterine system and the transcervical resection of endometrium in treating menorrhagia without organic uterine disease. Methods：In this prospective study，96 patients with menorrhagia were divided into two groups after the informed consent，LNG-IUS group with 46 cases and TCRE group with 50 cases. The bleeding volume，hemoglobin and side-effects of two groups were compared. Results：The bleeding amounts of both groups were reduced effectively after treatment，while the effect of TCRE was better than that of LNG-IUS （P＜0.05）. There was not significant difference between two groups in hemoglobin（P＜0.05），and there were not severe complications in two groups. The rat of side effects in the LNG-IUS group （69.6%） was more than that in the TCRE group （14%）. Conclusions：Both LNG-IUS and TCRE can reverse the menorrhagia without organic uterine disease. LNG-IUS is suitable for the young patients who require the reserving of eugenesis and TCRE for the patients who do not want prengancy any more.

Key words: Delayed-action preparations, Intrauterine devices, medicated, Levonorgestrel, Electrosurgery, Hysteroscopy, Endometrium, Menorrhagia