Retrospective Clinical Analysis On Treatment Of Adenomyosis By ?B Leuprolide Combined With LNG-IUS

Objectives: Through the retrospective analysis of 150 cases of adenomyosis in our hospital clinic, to compare the regimen and side effects of the treatments of LNG-IUS and AB leuprolide combined with LNG-IUS, and to explore the combined effect of the program on the treatment of uterine adenomyosis in the larger uterus(9.0cm<Uterine long diameter<14.0cm),thus to provide the basis for conservative treatment for the clinical treatment of adenomyosisMethods: 150 patients with Adenomyosis (AM) were selected from the putpatient department of gynaecology in the first affiliated hospital of Kunming Medical University from January 2015 to September 2016.All patients were diagnosed as Adenomyosis .by transvaginal ultrasonography. Patients were divided into group A (n=50). group B (n=38) and group C (n=62) according to the treatment methods and Uterine long diamete.In A group : 9.0cm<Uterine long diameter<14.0cm , In B group : Uterine long diameter <9.0cm ,All patients in A group and B group were treated by AB leuprolide combined with LNG-IUS,In C group : patients were treated by LNG-IUS alone .Retrospective analyze the severally improvement of symptoms (menstrual quantity, dysmenorrhea score,Uterine long diameter) and the rate of adverse reactions of the three groups after the treatment of 1 month/3 months/ 6 months. Patients in A?B group were placed LNG-IUS by the time of subcutaneously injectioned the last Leuprorelin Acetate Microspheres Sustained Releasa.Since some patients' menstruation did not recover after 1 month and we can have a better result 6 months later, so we evaluate the treatment effects by the patients' situations after 6 months'treatment .The relevant data are processed using SPSS22.0 statistical software for analysis, enumeration data and measurement data are expressed as a percentage(%),mean + label format (x±s), and use x2 test, t test,respectively.Results: (1) Patient menstrual score, dysmenorrhea score and uterine diameter changes.In group A, the menstrual quantity was 111.100+9.861 before receiving the treatment while the score was lower to 64.063+29.457 after 6 months, treatment; the dysmenorrhea score was 2.140±0.833 prior treatment while posttreatment score was0.231+0.144. And the uterine diameter is narrowed from 11.800+1.98cm to 7.62+1.320cm.In group B, the menstrual quantity score was 106.414+9.532 before treatment and the score was 52.120±6.245 after treatment; the dysmenorrhea score was2.015+0.968 prior treatment while posttreatment score was0. 186±0.065, the uterine diameter is 8.52+1.48cm befor treatment while the uterine volume is narrowed to 6.96+1.30cm.In group C, the menstrual quantity was 108.500+9.415 before receiving the treatment while the score was lower to64.324+4.245 after 6 months, treatment; the dysmenorrhea score wasl.980+0.968 prior treatment while posttreatment score was 0.432±0.265. And the uterine diameter is narrowed from 8.43±1.515cm to 7.48±1.703cm.The menstrual quantity, dysmenorrhea score , uterine diameter of all patients were improved after treatment (P<0.05) .In group A. B, the improvement of menstrual quantity dysmenorrhea score of group B are better than the group A (P<0.05) ..Ingroup B and C, the improvement of menstrual quantity dysmenorrhea score of group B are better than the group C (P<0.05).(2) Adverse reactions occurred in patients:In group A, decyclization was found in 2 case, abnormal vaginal bleeding was found in17 cases, backache was found in 4 cases, amenorrhea was found in 8 cases,one patient had ovarian cyst.In group B, none of patients had decyclization ovarian cyst. abnormal vaginal bleeding was found in 3 cases, backache was found in 2 cases, amenorrhea was found in 12 cases.In group C, decyclization was found in 2 case, abnormal vaginal bleeding was found in28cases, backache was found in 10 cases, amenorrhea was found in 8 cases,8 patients had ovarian cyst.Comparation of adverse events : In group A and group B, group B was lower than group A (P<0.05),In group A and group C, group B was lower than group C (P<0.05)Conclusions: (1) Intrauterine placement of LNG-IUS can effectively treat adenomyosis ;(2) AB leuprolide combined with LNG-IUS on the uterus larger(9.0cm<uterine diameter ? 14.0cm),also have a good therapeutic effect ;(3) For similar uterine size, AB leuprolide combined with LNG-IUS is better than LNG-IUS alone ;(4) AB leuprolide combined with LNG-IUS was superior to uterine uterus (9.0cm <uterine diameter <14.0cm) in patients with uterine uterine diameter <9.0 cm.