新型宫腔内打结法固定左炔诺孕酮宫内缓释系统的临床研究  

Clinical study on a novel intrauterine knotting method for fixing levonorgestrel intrauterine sustained-release system

作　　者：宋小磊 柯妍 热娜 彭娘海 曹文明 刘萍[2] 陈春林[2] SONG Xiao-lei;KE Yan;RE Na;PENG Niang-hai;CAO Wen-ming;LIU Ping;CHEN Chun-lin(Department of Gynecology,Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine,Shenzhen 518104,China;不详)

机构地区：[1]深圳市中西医结合医院妇科,广东深圳518104 [2]南方医科大学南方医院妇科,广东广州510515

出　　处：《中国实用妇科与产科杂志》2023年第7期745-748,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：2019年广东省临床教学基地教学改革研究项目(2019JD079);深圳市“医疗卫生三名工程”资助(SZZYSM202106003);深圳市卫生健康委员会医学菁英人才项目。

摘　　要：目的 探讨新型宫腔内打结法(new intrauterine knotting method,NIKM)用于固定左炔诺孕酮宫内缓释系统(LNG-IUS)的可行性和安全性。方法 对2018年12月至2022年3月在深圳市中西医结合医院接受LNG-IUS治疗的36例子宫腺肌病患者的临床资料进行回顾性分析。根据匹配对照法,其中18例患者采NIKM作为研究组,18例患者采用预固定LNG-IUS打结法作为对照组。NIKM引入活结理念,将线结于宫腔外完成后不借助任何进入宫腔的器械,牵拉缝合线的一端,完成线结的收紧,同时不预固定LNG-IUS,更符合宫内节育器放置操作流程及无菌操作原则。收集两组患者的手术及预后相关指标并进行比较。结果 两组患者的年龄、体重指数、手术方式比较,差异均无统计学意义(P>0.05)。两组患者的生育史、症状、术中出血量、术后并发症比较,差异均无统计学意义(P>0.05)。两组患者的发热率比较,差异无统计学意义(P>0.05),而手术时间与治疗费用差异具有统计学意义(P<0.05)。两组患者在治疗前后子宫大小无明显差异(P>0.05),而疼痛视觉模拟评分法(VAS)评分具有显著差异(P<0.05)。结论 NIKM对固定LNG-IUS安全可行,在住院时间、术中出血量、手术时间等方面与预固定LNG-IUS打结法无差别,但治疗费用更低,更符合宫内节育器放置流程,更符合无菌原则,同时也可以做到更换LNG-IUS时不需要拆除缝合线。Objective To explore the feasibility and safety of a new intrauterine knotting method(NIKM)for the fixation of levonorgestrel intrauterine sustained-release system(LNG-IUS).Methods A retrospective analysis was conducted on the clinical data of 36 patients with adenomyosis who received levonorgestrel intrauterine sustained-release system treatment at Shenzhen Integrated Traditional Chinese and Western Medicine Hospital from December 2018 to March 2022.According to the matched control method,18 patients treated with NIKM were as the study group,and 18 patients treated with pre fixed Levonorgestrel intrauterine sustained-release system knottingwere as the control group.NIKM introduced the concept of a flexible knot,which involved pulling one end of the suture without any instruments entering the uterine cavity to tighten the knot.At the same time,it did not pre-fix the levonorgestrel intrauterine sustained-release system,which was more in line with the operational process and sterile operation principles of intrauterine device placement.Collect and compare surgical and prognostic related indicators between two groups of patients.Results There was no statistically significant difference in age,body mass index,or surgical procedure between the two groups of patients(P0.05).There was no statistically significant difference in the fertility history,symptoms,intraoperative blood loss,or postoperative complications between the two groups of patients(P0.05).The difference in fever rates between the two groups of patients was not statistically significant(P0.05),while the difference in surgical time and cost was statistically significant(P0.05).There was no significant difference in uterine size between the two groups of patients before and after treatment(P0.05),while there was a significant difference in VAS score(P0.05).Conclusion NIKM is safe and feasible for the fixation of levonorgestrel intrauterine sustained-release system.There is no difference between NIKM and pre-fixed levonorgestrel intrauterine sustained-releas

关 键 词：新型宫腔内打结法 活结理念 预固定左炔诺孕酮宫内缓释系统打结法 节育器放置流程 无损更换节育器 可行性 安全性 

分 类 号：R713.4[医药卫生—妇产科学]