Recent Clinical Observation Of GnRH-a Combined With LUG-IUS Treatment Of Large Adenomyosis And Uterus Leiomyoma

Objective: To study the recent clinical observation of GnRH-a combined with LUG-IUSin treatment of large adenomyosis and uterus leiomyoma,and provide clinical treatment ofadenomyosis and uterus new ideas.Methods: We selected45cases based on clinical symptoms、signs and color dopplerdiagnosis of patients with adenomyosis(mesaured uterine length≥10cm，average age40±4years),including21cases with uterus leiomyoma,received injections of Gonadotropinreleasing normone analogue（GnRH-a Leuprorelin; brand name:BeiYi)3.75mg every4weeks, and after the uterine cavity depth was reduced to below9cm,Levonorgestrel-releasing intrauterine(LNG-IUS;brand name:Mirena) was deployed.Verbalrating scale(VRS),and PBAC scores were compared before the treatment of GnRH-a and at3、6、9、12months after LNG-IUS placement;B-shaft measured values of the size of theuterine and uterus leiomyoma to calculate uterine and uterus leiomyoma volume at the timeof the LNG-IUS placement and at3、6、9、12months after LNG-IUSplacement,which,uterine and uterus leiomyoma volume were calculated accordingtoVolume of an ellipsoid,that ellipsoid volume=0.52*a*b*c(abcfor the value of the lengthof each axis).Results: The VRS pain scores and PBAC bleeding scores were significantly lowerer at3，6,9and12months after LNG-IUS placement than before the treatment of GnRH-a(P＜0.05)，the score at12month after LNG-IUS placement was lower than that at3、6、9months after LNG-IUS placement (P＜0.05),the score at3month after LNG-IUSplacement was higher than that at6,9months(P＜0.05),but the score at6,9months afterLNG-IUS placement were not significant from each other(P＞0.05)；The uterine volume decreased significantly at the time of LNG-IUS placement than before the treatment ofGnRH-a（P＜0.05），The uterine volume increased at3、6、9、12months after LNG-IUSplacementat as compared with that at the time of the LNG-IUS placement，but theuterine volume decreased than before the treatment of GnRH-a（P＜0.05）, The uterinevolume at12month after LNG-IUS placement and at the time of LNG-IUS placementwere not significant from each other(P＞0.05), but the uterine volume decreased at12month after LNG-IUS placement than at3、6、9month after LNG-IUS placement （P＜0.05）;Uterus leiomyoma volume decreased significantly at the time of LNG-IUSplacement than before the treatment of GnRH-a（P＜0.05），The uterus leiomyoma volumeincreased at3、6、9、12months after LNG-IUS placementat as compared with that at thetime of the LNG-IUS placement，but the uterine volume decreased than before thetreatment of GnRH-a, The uterine volume at3month after LNG-IUS placement decreasedthan before the treatment of GnRH-a (P＜0.05), Even though the uterine volume at6、9、12months decreased a little than before the treatment of GnRH-a,but were not significantfrom each other（P＞0.05）.Conclusion: GnRH-a combined with LUG-IUS injection can be effective for the largeadenomyosis with dysmenorrhea and menorrhagia, it can improve the patients livingquality, and is quite promising in the clinical application, GnRH-a is more effective thanLNG-IUS in the decrease of the volume of uterus leiomyoma.