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目的探讨H形病灶切除术与LNG-IUS联合治疗子宫腺肌病的临床疗效与安全性。方法选取2014年9月至2015年2月68例子宫腺肌病患者,给予H形病灶切除术、左炔诺孕酮宫内缓释系统(LNG-IUS)联合治疗,观察疾病的临床治疗效果,分析联合治疗的安全性。结果随访期间,术后1个月、术后3个月、术后6个月、术后12个月痛经VAS疼痛评分、子宫体积、月经量评分及血清CA125与术前比较差异均有统计学意义(P<0.05);随访的不同时间点与前一时间点比较发现,各项数据均发生明显变化,差异有统计学意义(P<0.05)。12例有生育要求的患者中有10例患者符合妊娠标准,并成功取出LNG-IUS后接受试孕或辅助受孕。不良反应:不规则出血发生16.18%;乳房胀痛发生11.76%;LNG-IUS脱落发生2.94%。1年随访期间无复发情况发生。结论子宫腺肌病采取H形病灶切除术与LNG-IUS联合治疗,临床效果突出,安全性高,存在较高的临床应用价值。
Objective To investigate the clinical efficacy and safety of H-shaped resection combined with LNG-IUS in the treatment of adenomyosis. Methods Sixty-eight patients with adenomyosis from September 2014 to February 2015 were enrolled in this study. H-shaped resection and levonorgestrel-releasing intrauterine system (LNG-IUS) were used to observe the clinical effect of the disease , Analyze the safety of combination therapy. Results During the follow-up period, VAS pain score, uterine volume, menstrual volume and serum CA125 in 1 month postoperatively, 3 months postoperatively, 6 months postoperatively and 12 months postoperatively were statistically different from preoperative (P <0.05). Compared with the previous time point, the data of all the follow-up were significantly changed, the difference was statistically significant (P <0.05). Ten of 12 patients with fertility requirements met the pregnancy criteria and received either a test pregnancy or assisted pregnancy after LNG-IUS was successfully removed. Adverse reactions: irregular bleeding occurred 16.18%; breast tenderness occurred 11.76%; LNG-IUS shedding occurred 2.94%. No recurrence occurred during 1-year follow-up. Conclusion H adenocarcinoma with H-shaped resection and LNG-IUS combined treatment, the clinical effect is outstanding, safe, there is a high clinical value.