Observation On The Clinical Effect Of LNG-IUS In Treating Adenomyosis After Endometrial Resection

Objective To explore the clinical effect of hysteroscopic transcervical resection of endometrial(TCRE)with LIN-IUS in the treatment of the patients with adenomysis,and evaluate its clinical application value in order to provide patients with a more effective treatment.Methods The patients with adenomyosis who want to keep uterus without fertility requirements from January 2018 to January 2019 were divided into observation group and control group.The observation group was 42 patients who placed menyuele after hysteroscopic endometrial electrotomy,and the control group was 39 patients who simply placed menyuele after the month was clean or nearly clean.After one month,three months,six months and one year of treatment,the differences of uterine volume,endometrial thickness,dysmenorrhea degree,menstrual volume and hemoglobin value between the two groups were compared.The patients were instructed to use sanitary napkin of the same brand and size,record the days of each menstruation,menstrual volume,use PBAC to judge the situation of menstrual bleeding,use VAS(visual analog scoring method)to evaluate the severity of dysmenorrhea,and use the formula of uterine volume calculation v=0.52�length�front and rear diameter�Lateral diameter was used to calculate the size of uterus before and after treatment,and adverse reactions,such as the rate of ring removal,irregular vaginal bleeding and other uncomfortable symptoms,were recorded in the two groups.Spss19.0 statistical software was used to analyze the measurement data.(?x�s)was used to represent the measurement data.T-test was used.F-test was used to compare the data of multiple groups,and%was used to represent the count data,?~2 test was used,P<0.05 to represent the statistical significance.So we can get the clinical effect of the two treatment schemes.Results(1)General data:there was no statistical difference between the two groups in the preoperative uterine volume,dysmenorrhea degree,age,pregnancy times,anemia degree,uterine volume,endometrial thickness,menstrual volume,dysmenorrhea degree(P>0.05),which could be statistically analyzed.(2)The amount of menstruation,the thickness of endometrium and the volume of uterus before and after the treatment were significantly reduced compared with those before the operation,the VAS score was also lower than that before the operation,the hemoglobin value was increased compared with that before the operation,and the difference was statistically significant(P<0.05).(3)Compared with the control group,there was no significant difference in dysmenorrhea,uterus size and hemoglobin between the two groups(P>0.05).(4)There were significant differences in menstrual volume and endometrial thickness between the two groups after one month,three months,six months and one year of treatment(P<0.05).(5)The follow-up results showed that there were no patients in the observation group who had ring moving down and falling off,2 patients with drip like vaginal bleeding,2patients with prolonged menstrual period,1 patient with papillary distention and pain,and the incidence of adverse reactions in the observation group was 11.9%.In the control group,there were 2 patients with ring moving down and falling off,7 patients with vaginal drip bleeding,5 patients with prolonged menstrual period,2 patients with papillary distention and pain.The incidence of adverse reactions in the control group was 41.03%.The adverse reactions of the two groups were compared(P<0.05).Conclusion(1)The symptoms of adenomyosis can be improved by placing manyuele and only manyuele after hysteroscopic endometrial electrotomy.(2)After hysteroscopic endometrial electrotomy,placement of manyuele is superior to placement of manyuele alone in improving menstrual volume and endometrial thickening.(3)The complications of placing meniscus after hysteroscopic endometrial electrotomy are less than that of meniscus and can make up for the deficiency of meniscus treatment.