| Objective:To study the clinical curative effect of hysteroscopic resection combined with LNG-IUS treatment of uterine adenomyoma.Method: Eighteen cases of uterine adenomyoma underwent hysteroscopic resection combined with LNG-IUS treatment were selected from January 1,2014 to April 30,2015 in our hospital.The conditions of selecting cases:(1)There were excessive menstruation or severe dysmenorrhea symptoms,or both at the same time;(2)The uterine adenomyoma was found by ultrasound MRI examination,and inside the uterine cavity,the volume of uterine adenomyoma < 60 x 60 x 60mm3,From the serosa of adenomyoma was greater than or equal to 5mm,the depth of the uterine cavity<12cm;(3)The cases strongly required to retain the uterus,but they were no fertility requirements;(4)The cases were treated by medications or application of Mirena,the effect was not satisfied.Accepted a follow-up study in 1,3,6,1 2 months after operation.The operation time ? blood loss ? intraoperative and postoperative complications were recorded,and the changes of menstrual volume?uterine volume and uterine adenomyoma were compared.Result:1.In 18 cases,the operation time was(58.3±6.4)min,and there was no intraoperative and postoperative complications performed.The average length of hospitalization was(4.6 ±1.3)day.The pathology was broken smooth muscle tissue,and there were some endometrial glands and stroma.2.Postoperative follow-up of 6-12 months,in 14 cases of dysmenorrhea,14 cases of dysmenorrhea were followed up for 6 months.The follow-up results were consistent at each stage after operationand,2 cases were followed up for 12 months.2(2/14,14.3%)cases of partial remission,5(5/14,35.7%)cases were relieved,5(5/14,35.7%)cases of complete remission,2(2/14,14.3%)cases without menstruation.In 14 cases of menorrhagia,6 months after the operation,the volume of menstruation was decreased for the preoperative(29.3 +0.7)%,the period were reduced from(7.8 +3.3)d to(4.3 + 2.2)d.In addition,the difference was statistically significant(P<0.05);There was no significant difference in the postoperative period of the menstrual cycle(P > 0.05).The anemia were corrected in cases with anemia of different degree.The uterine volume were reduced from(232.5±94.5)cm3 to(123.8±59.4)cm3 in 6 months after the operation,the difference was statistically significant(P < 0.05),follow-up ultrasound showed no recurrence of uterine adenomyoma.3.In 6 months after the operation,1 cases was found to have a downward movement of the LNG-IUS position,and was replaced under the hysteroscopy,the remaining 17 cases had not moved down and falled off.In 8 patients(8/18),the amount of vaginal discharge was more than the preoperative;In 4 patients(4/18)were found functional ovarian cysts by Ultrasound,no symptoms,no special medical intervention and follow-up observation of 3-6 months,ovarian cysts ware decreased or disappeared;Four cases(4/18)had a bit of vaginal bleeding within 3 months after the surgery,which ware recovered to normal in 3-6 months;1 patient(1/18)weight increased;2 patients were unsatisfied because of vaginal discharge,and the rest were satisfied.Conclusion:1.The short term curative effect is obvious of hysteroscopic uterine adenomyosis lesion resection combined with LNG-IUS treatment of adenomyoma.Compared with preoperative,postoperative dysmenorrhea had varying degrees of ease,menstrual volume was reducted,menstrual was shortened and uterine volume significantly reduced.Can be used as a surgical option for patients with uterine adenomyoma who have no fertility requirements and do not wish to remove the uterus.2.large numbers of vaginal secretions?vaginal spotting bleeding?functional ovarian cysts and other adverse reactionswere caused by LNG-IUS,influence patient satisfaction.Satisfaction with the overall operationwas preferred.3.The sample quantity of this study is small,the follow-up time is short,it is necessary to increase the sample quantity,extend the follow-up time,to observe the long-term curative effect. |
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