The Clinical Observation And Follow-up Examination Of Adenomyosis Treated With Mirena

Objective:To investigate the clinical efficacy,Prognostic factor and adverse reactions of the Levonorgestrel-releasing Intrauterine System(Mirena,LNG-IUS)for the adenomyosis.Methods: Chose 206 patients who were diagnosed with adenomyosis and treated with Mirena as the research object from the obstetricsent and gynecology clinic of the First Affiliated Hospital of Shihezi University from January 2012 to December 2016.The patients were followed-up before and after Mirena placement at 1,3,6,12,24,36 months,respectively.Recorded menstrual cycle,menstrual period,menstrual blood volume,dysmenorrhea VAS score changes,endometrial thickness,the volume of uterus and the accompanying symptoms.Results:(1)Before the placement,the differences of menstrual period,menstrual blood volume,dysmenorrhea VAS score and endometrial thickness of the patients are statistically significant while there is no differences in menstrual cycle and the volume of uterus.(2)The effects of Mirena in different time quantum were analyzed.The differences of the effect of the Mirena placement at 1,6,12 month were statistically significant while there is no differences from the first year to the third year.(3)(group 1: menorrhagia +dysmenorrhea;Group 2: menorrhagia;Group 3: dysmenorrhea;Group 4: no obvious osymptoms.menorrhagia >30pieces/month,dysmenorrhea VAS score>3).The effect of Mirena was no difference among all symptom groups.(4)The working time in different symptom groups is statistically significant(group 1> group 3;group 2 > group 3;Group 4 > Group3);(5)There is no difference of the amenorrhea rate in different symptom groups;(6)These factors(age,the endometrial of pathological examnation,dilatation and curettage,kupperman score,the interphase vaginal drop bleeding,weight gain)were irrelevant to the prognosis of the patients;(7)The major adverse reactions include interphase vaginal drop bleeding,the expulsion of Mirena,functional ovarian cysts,weight gain,aestates,acne,hemorrhoid and a series of menopausal symptoms(kupperman score),etc.Conclusion:(1)Mirena can effectively treat the adenomyosis and the therapeutic effect in different periods are of significance,the trend is stable after one year.(2)The working time of different symptom groups are different: no obvious symptom/menorrhagia + dysmenorrhea/menorrhagia<dysmenorrhea;(3)The Mirena is effective and with less side effects,high satisfaction and high clinical value.