The Clinical Efficacy Analysis Of GnRHa And Levonorgestrelreleasing Intrauterine Sestem For The Treament Of Atypical Endometrial Hyperplasia

ObjectiveTo investigate the effect of GnRHa and levonorgestrelreleasing intrauterine system(Mirena)in the treatment of atypical endometrial hyperplasia.MethodsFrom September 2013 to September 2016,36 AEH patients Visiting to the Qingdao Municipal Hospital Gynecological Center were collected.All of them underwent hysteroscopic diagnostic curettage pathology were confirmed AEH.They were divided into two groups,experimental group of 17 cases,Mirena was inserted after 3 courses of GnRHa(goserelin)treatment;The control group of 19 cases were directly inserted Mirena.The menstrual flow,endometrial thickness,endometrial pathology and vaginal drip bleeding in two groups before and after treatment by Mirena for 3 months,6 months and 12 months were compared.ResultsThe experimental group The PBAC scores of menstrual flow were respectively 141.1±44.7,36.5±12.7,22.5±7.8,13.2±2.6 before treated by Mirena and three months,six months,twelve months after treated,the difference was significant statistically(P<0.05);Endometrial thickness were respectively 14.4±4.1mm,7.8±2.0mm,5.9±1.6mm,5.2± 1.2mm before treated by Mirena and three months,six months,twelve months after treated,the difference was significant statistically(P<0.05).After treated Mirena three months,15 patients reversed pathological changes,By the six months follow-up period,all of the patients reversed pathological changes.The treatment efficiency reached 100%.The control group The PBAC scores of menstrual flow were respectively 130.8±41.4,48.7± 10.6,30.2±8.1,15.2±2.7 before treated by Mirena and three months,six months,twelve months after treated,the difference was significant statistically(P<0.05);Endometrial thickness were respectively 14.3±4.2mm,9.3±2.1mm,7.0±1.6mm,5.6±1.3mm before treated by Mirena and three months,six months,twelve months after treated,the difference was significant statistically(P<0.05).After 3 months of treatment,the endometrium was reversed in 11 cases,and 14 cases were found after 6 months.At the end of follow-up,there were still 3 cases without pathological changes.The total effective rate was 84.2%.Experimental group compared with the control group,the menstrual flow scores was lower,the thickness of the endometrium was thiner,the effective rate was higher,and the vaginal bleeding was lower,after treatment by Mirena for 3 months,6 months,the difference was significant statistically(P<0.05).But two groups of menstrual flow scores,endometrial thickness,the effective rate was no significant difference after treatment by Mirena for 12 months(P>0.05).During the entire follow-up period,8 patients in the control group appear vaginal drip bleeding.Only 2 patients in the treatment group appear this symptom.The difference was significant statistically(P<0.05).ConclusionMirena can effectively treat atypical endometrial hyperplasia;GnRHa combined with Mirena has significant effects on reducing intermenstrual vaginal bleeding in using of Mirena;Compared with Mirena only,GnRHa combined with Mirena is more effective in the treatment of atypical endometrial hyperplasia.