| Backgrounds and ObjectiveMenorrhagia is the most common clinical manifestations of women in childbearing age,but also seriously troubled health problem.Some medical diseases or their treatment can cause menorrhagia.Moreover,menorrhagia with medical diseases may have hormone therapy contraindications or high risk of surgery and the choices of menorrhagia treatment options are limited.Now we try to use levonorgestrel-releasing intrauterine system(LNG-IUS)treating menorrhagia among women with medical diseases,the study is aimed to evaluate the efficacy of LNG-IUS treatment on menorrhagia with medical diseases and to explore its clinical application value through retrospective analysis.Materials and MethodsCollected clinical data of hospitalized patients in the use of LNG-IUS treatment for menorrhagia in January 2011-January 2016 in the First Affiliated Hospital of Zhengzhou University,by exclusion criteria,the number of eligible patients were 80,the patients with medical diseases were 36,the specific medical diseasesare as follows,renal insufficiency(6cases),hematological diseases(5cases),systemic lupuseryth ematosus(3cases),liver dysfunction(5 cases),postoperative of breast cancer(5 cases),postoperative of heart valve replacement(1 case),diabetes mellitu(3 cases),thyroid disease(8 cases);The patients without complicated medical diseases were 44;Menstrual quantity,hemoglobin,endometrium thickness,adverse reactions,satisfaction rates,pregnancy and progress in their own medical diseases were recorded before and after levonorgestrel-releasing intrauterine system insertion in 3,6 months by outpatient review or telephone inquiry.Results1.In the group with medical diseases,the baseline characteristics were as follows,the age was(39.0±8.4)years,body mass index was(23.8±3.0)kg /m2,pregnancy times was(2.92±1.42)times,production times was(1.56±0.94)times,hemoglobin levels was(85.2±13.0)g/L and endometrial thickness was(11.2±2.4)mm when hospitalized;In the other group without medical diseases,the baseline characteristics were as follows,the age was(42.3±5.9)years,body mass index was(23.4±2.3)kg /m2,pregnancy times was(2.93±1.28)times,production times was(1.70±0.77)times,hemoglobin levels was(86.1±14.9)g/L,endometrial thickness was(11.0±2.3)mm.There was no significant difference in age,body weight index,pregnancy times,production times,hemoglobin levels,endometrial thickness in the two groups(P>0.01).2.In the group with medical diseases,there were 2 patients with LNG-IUS expulsions and 4 patients had no improvement in menstrual volume after 3 months of LNG-IUS placement,which included 1 patient's menstrual volume didn't improve due to LNG-IUS expulsion,there was 1 patient with LNG-IUS expulsion and 2 patients had no improvement in menstrual volume after 6 months of LNG-IUS placement;In the group without medical diseases,there were 2 patients with LNG-IUS expulsions and 2 patients had no improvement in menstrual volume after 3 months of LNG-IUS placement,there were 2 patients with LNG-IUS expulsions and 1 patient had no improvement in menstrual volume after 6 months of LNG-IUS placement.The effective rates were 86.1% and 91.2%,respectively,after 3 months and 6 months of LNG-IUS placement in patients with medical diseases,the effective rates were 90.9% and 92.2%,respectively,after 3 months and 6 months of LNG-IUS placement in patients without medical diseases,there was no significant difference in the effective rate in the two groups(P>0.05).3.The thickness of the endometrium were(11.2 ± 2.4)mm,(8.4 ± 1.7)mm,(6.1 ± 2.1)mm,respectively,before and after 3 months and 6 months of LNG-IUS placement in patients with medical diseases;The thickness of the endometrium were(11.0±2.3)mm,(8.0±1.9)mm,(5.8±1.4)mm,respectively,before and after 3 months and 6 months of LNG-IUS placement in patients without medical diseases.Compared with before placing LNG-IUS,the difference of endometrial thickness was statistically significant in the two groups(P<0.05);However,there was no significant difference between the two groups after 3 months and 6 months of LNG-IUS placement(P> 0.05).4.Hemoglobin levels were(85.2 ± 13.0)g / L,(91.5 ± 10.9)g / L,(101.5 ± 7.9)g / L,respectively,before and after 3 months and 6 months of LNG-IUS placement in patients with medical diseases;Hemoglobin levels were(86.1 ± 14.9)g / L,(93.6 ± 12.4)g / L,(102.3 ± 9.0)g / L,respectively,before and after 3 months and 6 months of LNG-IUS placement in patients without medical diseases.Compared with before placing LNG-IUS,the difference of Hemoglobin levels was statistically significant in the two groups(P<0.05);However,there was no significant difference between the two groups after 3 months and 6 months of LNG-IUS placement(P> 0.05).5.The main adverse reactions were vaginal spotting and irregular bleeding after the placement of LNG-IUS.The satisfaction rate was 83.3%(30/36)and 79.5%(35/44)after 6 months of LNG-IUS placement in the two groups.6.All patients in the group with medical diseases continued treatment of primary medical diseases after placement of LNG-IUS and none of the primary medical diseases progression during the 6-month follow-up period.7.No case of patients with pregnancy in the two groups during the 6-month follow-up period after placement of LNG-IUS.Conclusions1.The levonorgestrel-releasing intrauterine system was an effective method in the treatment of menorrhagia.2.The levonorgestrel-releasing intrauterine system was also effective in the treatment of menorrhagia with medical diseases and its efficacy was similar to that without medical diseases;It is expected to be widely used in the treatment of menorrhagia with medical diseases due to its remarkable curative effect,effective contraception,less impact on primary medical diseases,high patient satisfaction. |
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