| Objective:To investigate the clinical efficacy and side effects of Levonorgestrel-releasing Intrauterine System(LNG-IUS;brand name: Mirena)in the treatment of adenomyosis.Method:Chose 109 patients who were diagnosed with adenomyosis and treated with LNG-IUS in Department of Gynaecology II of the First Hospital of Jilin University from September 2017 to December 2018 as the research objects.Outpatient follow-up was conducted at 1,3,6 and 12 months after LNG-IUS placement.1?Recorded menstrual cycle,menstrual period,menstrual blood volume,dysmenorrhea VAS scores,endometrial thickness,the volume of uterus,and side effects before and after LNG-IUS placement for 1,3,6 and 12 months..2?The changes in the thickness of the diseased part of the muscle layer in patients with diffuse adenomyosis were recorded before and after LNG-IUS placement for 1,3,6 and 12 months.3?The changes of adenomyoma volume in patients with adenomyoma were recorded before and after LNG-IUS placement for 1,3,6 and 12 months.Results:1?The menstrual cycle days in the first month after the placement of LNG-IUS were 30.00(28.00,30.00)days,with no statistically significant difference(P > 0.05).The menstrual cycle days in the 3 months after LNG-IUS placement were30.00(30.00,30.00)days,and the difference was not statistically significant(P >0.05).The menstrual cycle days in the 6 months after LNG-IUS placement were30.00(30.00,30.00)days,and the difference was not statistically significant(P >0.05).Themenstrual cycle days in the 12 months after LNG-IUS placement were30.00(30.00,30.00)days,and the difference was not statistically significant(P >0.05).2?The menstrual days in the first month after the placement of LNG-IUS were5.00(4.00,8.00)days,with no statistically significant difference(P > 0.05).The menstrual days in the 3 months after LNG-IUS placement were 4.00(2.00,7.00)days,and the difference was statistically significant(P < 0.05).The menstrual days in the 6months after the placement of LNG-IUS were2.00(1.00,5.00)days,and the difference was statistically significant(P < 0.05).The menstrual days in the 12 months after the placement of LNG-IUS were 1.00(1.00,5.00)days,and the difference was statistically significant(P < 0.05).3?The menstrual volume score of the patients in the first month after LNG-IUS placement was 45.00(10.00,145.00),and the difference was statistically significant(P <0.05).The menstrual volume score in the 3 months after LNG-IUS placement was 20.00(10.00,80.00),and the difference was statistically significant(P < 0.05).The menstrual volume score of 6 months after LNG-IUS placement was 12.50(7.25,48.75),and the difference was statistically significant(P < 0.05).The menstrual volume score in the 12 months after LNG-IUS placement was 10.00(7.50,20.00),and the difference was statistically significant(P < 0.05).4?The dysmenorrhea score of the patients 1 month after LNG-IUS placement was 0(0,1.00),with statistically significant difference(P < 0.05).The dysmenorrhea score in the 3 months after LNG-IUS placement was 0(0,1.00),and the difference was statistically significant(P < 0.05).The dysmenorrhea score in the 6 months after LNG-IUS placement was 0(0,0),and the difference was statistically significant(P <0.05).The dysmenorrhea score of 12 months after LNG-IUS placement was0(0,0),and the difference was statistically significant(P < 0.05).5?The uterine volume was 82.32(62.41,111.05)cm3 1 month after LNG-IUS placement,with no statistically significant difference(P > 0.05).The uterine volume was71.65(57.50,102.66)cm3 3 months after LNG-IUS placement,and the difference was statistically significant(P < 0.05).The uterine volume at 6 months afterLNG-IUS placement was62.09(43.18,85.59)cm3,and the difference was statistically significant(P < 0.05).The uterine volume at 12 months after LNG-IUS placement was 51.04(34.95,69.89)cm3,and the difference was statistically significant(P <0.05).6?The endometrial thickness of the patients was 5.00(4.00,6.00)mm 1 month after LNG-IUS placement,and the difference was statistically significant(P < 0.05).The endometrial thickness was4.00(3.00,5.00)mm 3 months after LNG-IUS placement,and the difference was statistically significant(P < 0.05).The endometrial thickness was 3.00(3.00,4.00)mm 6 months after LNG-IUS placement,and the difference was statistically significant(P < 0.05).The endometrial thickness was 3.00(2.00,3.00)mm 12 months after LNG-IUS placement,and the difference was statistically significant(P < 0.05).7?In patients with diffuse adenomyosis,the thickness of the muscle layer at the lesion site of the anterior uterine wall was 20.00(16.00,25.00)mm 1 month after the placement of LNG-IUS,and the difference was not statistically significant(P > 0.05).Three months after LNG-IUS placement,the thickness of myometrium at the lesion site of the anterior uterine wall was 19.00(15.00,24.00)mm,and the difference was statistically significant(P < 0.05).Thee thickness of the muscle layer at the lesion site of the anterior uterine wall was17.00(13.00,22.00)mm 6 months after the placement of LNG-IUS,and the difference was statistically significant(P < 0.05).The thickness of myometrium at the lesion site of the anterior uterine wall was 14.00(10.00,18.00)mm 12 months after LNG-IUS placement,and the difference was statistically significant(P < 0.05).8?In patients with diffuse adenomyosis,the thickness of the muscle layer at the lesion site of the posterior wall was 24.00(20.00,28.75)mm 1 month after the placement of LNG-IUS,and the difference was not statistically significant(P > 0.05).The thickness of the muscle layer at the lesion site of the posterior wall was23.00(19.00,26.00)mm 3 months after the placement of LNG-IUS,and the difference was statistically significant(P < 0.05).After 6 months of LNG-IUS placement,the thickness of the muscle layer at the lesion site of the posterior wall was 23.00(20.00,27.00)mm,and the difference was statistically significant(P < 0.05).After12 months of LNG-IUS placement,the thickness of the muscle layer at the lesion site of the posterior wall was20.00(17.00,25.00)mm,and the difference was statistically significant(P < 0.05).9?The uterine adenomyoma volume in 1 month after LNG-IUS placement was0.77(0.41,1.09)cm3,and the difference was statistically significant(P < 0.05).The adenomyoma volume in the 3 months after LNG-IUS placement was0.66(0.34,1.01)cm3,and the difference was statistically significant(P < 0.05).The adenomyoma volume at 6 months after LNG-IUS placement was 0.55(0.27,0.88)cm3,and the difference was statistically significant(P < 0.05).The adenomyoma volume at 12 months after LNG-IUS placement was 0.39(0.09,0.57)cm3,with statistically significant differences(P < 0.05).10?Main side effects include:vaginal spotting during the interphase,removal of rings and pigmentation of facial skin.Conclusions:1?LNG-IUS has no significant effect on the number of days of menstrual cycle in AM patients.2?LNG-IUS shortens the menstrual period of AM patients,reduces menstrual volume,thins the endometrium,improves dysmenorrhea,and reduces the uterine volume and lesion volume.3?Patients with AM have fewer adverse reactions after the placement of LNG-IUS,which is of high clinical application value. |
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