Clinical Observation Effet Of Lng-ius On Adenomyosis

Objective:To investigate the clinical efficacy of Levonorgestrel-releasing Intrauterine System(LNG-IUS)and its different placement periods in the treatment of adenomyosis(AM)through a retrospective and comparative analysis of 115 patients undergone the conservative treatment of AM.Methods:115 patients with AM treated in Department of Gynecology,the Affiliated Hospital of Yanbian University from January 2016 to September 2018 were investigated.All patients had no pregnancy requirements temporarily and underwent conservative treatment.According to patient preference,they were divided into an observation group and a control group,with 61 patients who chose LNG-IUS conservative treatment in the observation group and 54 patients who chose oral mifepristone conservative treatment in the control group.The changes of menstrual period,menstrual volume score,dysmenorrhea score,endometrial thickness and Cancer antigen 125(CA125)level were compared in each group between 3 and 6 months after treatment and before treatment.Also,the changes of menstrual period,menstrual volume score,dysmenorrhea score,endometrial thickness and CA125 level were compared between the two groups in 3 and 6 months after treatment.Meanwhile,the observation group,namely LNG-IUS conservative treatment group,was divided into Group A and Group B according to different placement periods,with 30 patients who were placed on Day 3-5 during the menstrual period in Group A and 31 patients who were placed on Day 3-7 during the clean period in Group B.The statistical analysis of menstrual period,menstrual volume score and dysmenorrhea score in the two groups was performed in 3 and 6 months after treatment,and the clinical efficacy was compared between the two groups.Results:(1)The menstrual volume scores of the observation group in 3 and 6 months after treatment were both lower than before treatment(3 months,P<0.05;and 6 months.P<0.01);the menstrual volume scores of the control group in 3 and 6 months after treatment were both lower than before treatment(P<0.05);and the menstrual volume score had no statistical significance between the two groups in 3 months after treatment(P>0.05),but the menstrual volume score of the observation group was obviously lower than that of the control group in 6 months after treatment(P<0.05).(2)The dysmenorrhea scores of the observation group in 3 and 6 months after treatment were both lower than before treatment(3 months,P<0.05;and 6 months,P<0.01);the dysmenorrhea scores of the control group in 3 and 6 months after treatment were both lower than before treatment(P<0.05);and the dysmenorrhea score had no statistical significance between the two groups in 3 months after treatment(P>0.05),but the dysmenorrhea score of the observation group was lower than that of the control group in 6 months after treatment(P<0.05).(3)The endometria of the observation group in 3 and 6 months after treatment were both thinner than before treatment(3 months,P<0.05;and 6 months,P<0.01);the endometria of the control group in 3 and 6 months after treatment were both thinner than before treatment(P<0.05);and the endometria of the observation group were both thinner than those of the control group in 3 and 6 months after treatment(P<0.05).(4)The CA125 levels of the observation group and the control group in 3 months after treatment were both lower than before treatment(P<0.05):the CA125 levels of the observation group and the control group in 6 months after treatment were both significantly lower than before treatment(P<0.01);and the CA125 levels of the observation group were both lower than those of the control group in 3 and 6 months after treatment(3 months,P<0.05;and 6 months,P<0.01).(5)There were no statistical differences between Group A and Group B in the menstrual period,menstrual volume score and dysmenorrhea score in both 3 and 6 months after LNG-IUS treatment(P>0.05).Conclusion:(1)Although both LNG-IUS and mifepristone have obvious therapeutic effects on the clinical symptoms of AM,such as menstrual change,dysmenorrhea.endometrial thickening and decrease of CA125 level,LNG-IUS has a better and more obvious effect than mifepristone;(2)There is no significant difference between LNG-IUS placed during the menstrual period and the clean period.