本文關(guān)鍵詞： LNG-IUS GnRHa 月經(jīng)過多 痛經(jīng)　出處：《重慶醫(yī)科大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的觀察左炔諾孕酮宮內(nèi)緩釋系統(tǒng)(Levonorgestrel-releasing intrauterine system,LNG-IUS,商品名:曼月樂)治療經(jīng)量過多和痛經(jīng)的有效性,比較其單用或與促性腺激素釋放激素激動(dòng)劑(Gonadotropin releasing hormone agonist,GnRHa)聯(lián)合使用的療效和副反應(yīng)。方法我院2007年7月至2013年10月期間因經(jīng)量過多及/或痛經(jīng),診為子宮腺肌癥(341例)、盆腔子宮內(nèi)膜異位癥(68例)和功血(101例)的患者共510例選擇安置LNG-IUS作為治療手段。對(duì)這部分患者進(jìn)行隨訪(3天-92月,中位隨訪時(shí)間21月)分析。結(jié)果87.4%(339/388)的經(jīng)量過多者治療后經(jīng)量有效減少,87.3%(377/432)合并痛經(jīng)或盆腔疼痛者治療后疼痛有效緩解。510例患者中,GnRHa聯(lián)合LNG-IUS治療者87例(17.1%),單用LNG-IUS治療者423例(82.9%)。與單用相比,聯(lián)合GnRHa應(yīng)用減少經(jīng)量(91.8%VS.86.5%,P=0.256)、緩解腹痛(91.8%VS.86.5%,P=0.326)的療效似乎更好,但無統(tǒng)計(jì)學(xué)意義。兩組間放置LNG-IUS后的自然脫落率(9.2%VS.8.5%,P=0.836)亦無統(tǒng)計(jì)學(xué)差異,不過相對(duì)單用而言,聯(lián)合Gn RHa應(yīng)用者環(huán)自然脫落時(shí)間更晚(中位脫落時(shí)間10.5月VS.3.5月,P=0.041)、被迫取出率更低(3.4%VS.12.8%,P=0.02),故患者滿意度也更高(86.2%VS.75.7%,P=0.032)。結(jié)論LNG-IUS不僅具有高效避孕的效果,還能有效減少月經(jīng)量、緩解痛經(jīng)和慢性盆腔痛。聯(lián)合Gn RHa/LNG-IUS與單用LNG-IUS相比,療效沒有顯著優(yōu)勢(shì),不過聯(lián)合應(yīng)用者LNG-IUS脫落時(shí)間更晚、被迫取出率更低、滿意度更高。
[Abstract]:Objective to observe the efficacy of Levonorgestrel-releasing intrauterine system LNG-IUSS (trade name: Manyue) in the treatment of menstrual overdose and dysmenorrhea. The efficacy and side effects of gonadotropin releasing hormone agonist GnRHawere compared with those of gonadotropin releasing agonist GnRHa.Methods from July 2007 to October 2013, our hospital suffered from excessive menstrual volume and / or dysmenorrhea. A total of 510 cases of adenomyosis, 68 cases of endometriosis and 101 cases of dysplasia) were treated with LNG-IUS. The patients were followed up for 3 days to 92 months. Analysis of median follow-up time (21 months). Results 87.4% of the patients with overdose (87.4% 339 / 388) were significantly reduced after treatment. (87.3% 377 / 432) pain relief after treatment with dysmenorrhea or pelvic pain. 87 cases were treated with GnRHa combined with LNG-IUS. 87 cases were treated with LNG-IUS alone. Of the 423 cases, 82.9%. Compared with the single use, The combination of GnRHa and VS.86.5VS.86.5VS.86.5VS.86.5VS.86.5VS.86.5VS.86.5VS.86.5VS.86.5VS.86.5P0.836between the two groups seems to be better, but there is no statistical significance. There is no statistical difference between the two groups after placing VS.8.5P0.836), however, there is no statistical difference between the two groups in terms of the natural fall off rate of VS.8.5P0.836. In combination with Gn RHa, the natural exfoliation time of the ring was much later (median abscission time was 10.5 months, VS.3.5 month was 0.041, forced removal rate was lower than 3.4VS.12.8cm), so the patient satisfaction was also higher (86.2VS.75.7P0.032.Conclusion LNG-IUS not only has the effect of effective contraception, but also can effectively reduce the menstrual volume. Compared with LNG-IUS alone, the combination of Gn RHa/LNG-IUS had no significant effect on relieving dysmenorrhea and chronic pelvic pain. However, the patients with combined use of Gn RHa/LNG-IUS had lower rate of forced removal and higher satisfaction with LNG-IUS.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R711.71;R711.51

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相關(guān)期刊論文 前2條

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本文編號(hào)：1528460