| OBJECTIVE Adenomyosis is one of common gynecological diseases. It’s very important to choose the methods with less truama and fewer side effects. The levonorgestrel releasing intrauterine system (LNG-IUS,Mirena) is an intrauterine device by which levonorgestrel could be released continuously. The aim of the present paper was to study on the clinical curative effect of adenomyosis treated by LNG-IUS, evaluate its functions and guide clinical application.METHODS 42 patients, with an average age of 38.5(30～46) years old, who were diagnosed as adenomyosis were collected at the gynecological clinic, Yanbian University hospital during Oct 2013 to Dec 2015. Under the patients’ informed consent, those patients were followed up before and 1,3,6,12 months after treating with LNG-IUS. The menstrual blood volume, dysmenorrhea score, hemoglobin level, the level of serum follicle stimulating hormone(FSH), luteotropic hormone(LH) and Estradiol(E2) on the second to fourth days of menstrual period, endometrial thickness and uterine volume measured by transvaginal color Doppler sonography were observed and evaluated. Adverse reactions and satisfaction with LNG-IUS of patients were investigated during follow-up period. SPSS 17.0 statistical software was used to analyse and process the data. Paired t test was used for dysmenorrhea score and the result was indicated by x±s. Randomized block design and Wilcoxon rank sum test were used for the rest. Multiple comparison adjustment test level was a=0.012. GraphPad 6.0 Prism software was used to product statistical chart.RESULTS 1.14 of 42 patients showed a small amount of irregular vaginal bleeding and 2 of them dropped out of treatment because of that. Two of 42 patients, one presents amenorrhea and another one’s LNG-IUS fall off, both dropped off treatment. Another two lost of follow-up. Finally,36 patients completed clinical follow-up for a period of 12 months.2. One month after treating with LNG-IUS, dysmenorrhea symptoms of all patients were significantly relieved. Dysmenorrhea score was reduced from 2.75+0.55 to 0.50 ±0.51. After three months treating, dysmenorrhea symptoms of all patients disappeared.3.1,3,6,12 months after treating with LNG-IUS, menstrual blood volume decreased significantly(P<0.012).4.1,3,6,12 months after treating with LNG-IUS, HGB level was significantly increased(P< 0.012). After 3 months treating, HGB level of 13 patients in anemia were all up to normal range.5. FSH, LH and E2 had no significant difference between before and after the treatment(P>0.012).6.1,3,6,12 months after treating with LNG-IUS, endometrium was thinner than before(P< 0.012). Uterine volumehad no significant difference between before and after the treatment(P>0.012).7. During the follow-up period, there were 14 patients showed a small amount of irregular vaginal bleeding,3 patients appeared breast pain, one had amenorrhoea, eight of their LNG-IUS was shift down and one of their LNG-IUS fell off.8. During the 12 months of follow-up period,40 patients,42 patients except for 2 of loss of follow-up, was investigated on the satisfaction degree. Comprehensive evaluation of LNG-IUS were rated very satisfied by 16 patients, satisfied by 17 patients, fair by 3 patients and dissatisfied by 4 patients(dropping out of treatment). The main reasons of dissatisfied were irregular vaginal bleeding, amenorrhea and LNG-IUS falling off. Patients had high satisfaction.CONCLUSION LNG-IUS could quickly and effectively relieve dysmenorrhea caused by adenomyosis and reduce menstrual blood volume. It had small systemic side reaction and high satisfaction. It is a safe and effective method for the treatment of adenomyosis. |
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