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首页> 外文期刊>Journal of women’s health >Levonorgestrel-releasing intrauterine system versus laparoscopic supracervical hysterectomy for the treatment of heavy menstrual bleeding: A randomized study
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Levonorgestrel-releasing intrauterine system versus laparoscopic supracervical hysterectomy for the treatment of heavy menstrual bleeding: A randomized study

机译：左炔诺孕酮子宫内释放系统与腹腔镜下子宫上子宫切除术治疗月经大量出血：一项随机研究

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Background: The optimal treatment of heavy menstrual bleeding (HMB) remains a challenge for the physician. There is a need for further trials to compare the effectiveness and compliance between a levonorgestrel-releasing intrauterine system (LNG-IUS) and minimally invasive types of hysterectomy, for example, laparoscopic supracervical hysterectomy (LSH), in women with HMB. This article is the first to report a randomized trial aimed at comparing postoperative outcomes and effects on quality of life after LNG-IUS or LSH in women with HMB. Methods: The trial was performed at Tor Vergata University Hospital, Rome. Seventy-two women requiring treatment for HMB were randomly allocated into two treatment arms: LNG-IUS (n=36) or LSH (n=36). The primary outcome was the comparison of the effects on menstrual bleeding (pictorial blood loss assessment chart [PBAC]) at 12 months after the two procedures. The secondary outcome measures were the quality of life, improvement in bleeding patterns, intensity of postoperative pain, and early postoperative complications. A p<0.05 was considered statistically significant. Results: The PBAC score was significantly reduced in both treatment groups. The Medical Outcomes Survey Short Form 36 (SF-36) score improved in both groups. A more significant improvement in the parameters Role and Mental health was observed after LNG-IUS. Conclusions: LNG-IUS can be considered as first option for the treatment of HMB unresponsive to drug therapy, and it is particularly suitable for women who want to preserve an acceptable menstrual flow. LSH may be considered the best surgical option in women with HMB unresponsive to any medical treatment.
机译：背景：重度月经出血（HMB）的最佳治疗仍然是医师的挑战。有必要进行进一步的试验，以比较在HMB妇女中，左炔诺孕酮释放子宫内系统（LNG-IUS）与微创类型子宫切除术（例如腹腔镜scopic上子宫切除术）的有效性和依从性。本文是首次报道一项随机试验，旨在比较HMB妇女LNG-IUS或LSH术后的结局及其对生活质量的影响。方法：该试验在罗马Tor Vergata大学医院进行。将需要HMB治疗的72名妇女随机分配到两个治疗组中：LNG-IUS（n = 36）或LSH（n = 36）。主要结果是比较两种手术后12个月对月经出血的影响（图形失血量评估图[PBAC]）。次要结果指标是生活质量，出血模式改善，术后疼痛强度和术后早期并发症。 p <0.05被认为具有统计学意义。结果：两个治疗组的PBAC评分均显着降低。两组的医学成果调查简表36（SF-36）得分均得到改善。 LNG-IUS后，在“角色”和“心理健康”参数方面有了更显着的改善。结论：LNG-IUS可以被认为是对药物治疗无反应的HMB的首选治疗方法，它特别适合想要保持可接受的月经量的女性。 LSH被认为是对任何药物均无反应的HMB妇女的最佳手术选择。

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