左炔诺孕酮宫内节育系统宫腔镜下放置者脱落发生的影响因素分析  

Analysis on factors influencing the falling off of levonorgestrel-releasing intrauterine system implanted under hysteroscope

作　　者：郑顺杰[1] 张琳[1] 胡旻[1] 金兰英[1] ZHENG Shunjie;ZHANG Lin;HU Min;JIN Lanying(Department of Gynecology,Jinhua Municapal Central Hospital,Jinhua 321000,China)

机构地区：[1]金华市中心医院妇科,321000

出　　处：《浙江医学》2023年第17期1851-1853,1881,共4页Zhejiang Medical Journal

摘　　要：目的探讨左炔诺孕酮宫内节育系统(LNG-IUS)宫腔镜下放置者脱落发生的影响因素。方法选取2018年1月至2022年1月金华市中心医院收治的LNG-IUS宫腔镜下放置者400例为研究对象,依据LNG-IUS放置者是否脱环将其分为脱环组30例和未脱环组370例。采用单因素分析和多因素logistic回归分析LNG-IUS宫腔镜下放置者发生脱落的影响因素。结果单因素分析显示,脱环组患者术前使用促性腺激素释放激素激动剂(GnRH-a)的比例小于未脱环组,子宫横径、子宫长径、子宫前后径均长于未脱环组,子宫体积大于未脱环组,差异均有统计学意义(均P<0.01)。多因素logistic回归分析显示,子宫横径长、子宫长径长、子宫前后径长、子宫体积大均为LNG-IUS宫腔镜下放置者发生脱落的危险因素(OR=5.114、4.674、5.099、4.978,均P<0.01),而术前使用GnRH-a为LNG-IUS宫腔镜下放置者发生脱落的保护因素(OR=0.233,P<0.01)。结论临床上可通过排查LNG-IUS宫腔镜下放置者的危险因素,并给予相应方案加以干预,降低LNG-IUS宫腔镜下放置者发生脱落的风险。Objective To explore the factors influencing the falling off of levonorgestrel-releasing intrauterine system(LNG-IUS)implanted under hysteroscope.Methods Four hundred cases who were admitted to Jinhua Municipal Central Hospital from January 2018 to January 2022 and received LNG-IUS implantation under hysteroscope were enrolled.Based on whether the LNG-IUS fell off,they were divided into a falling off group with 30 cases and a non-falling off group with 370 cases.Univariate analysis and multivariate logistic regression analysis were used to determine the influencing factors of hysteroscopic LNG-IUS falling off.Results Univariate analysis showed that before surgery,the proportion of gonadotropinreleasing hormone antagonist(GnRH-a)application in the falling off group was smaller than that of the non-falling off group.The length,width,and anteroposterior diameter of uterus in the falling off group were all larger compared with those of nonfalling off group,and the volume of the uterus in the falling off group was greater,all with statistically significant difference(all P<0.01).The results of multivariate logistic regression analysis showed that larger length,width,anteroposterior diameter,and volume of uterus were all risk factors for hysteroscopic LNG-IUS falling off(OR=5.114,4.674,5.099,and 4.978,all P<0.01),while preoperative use of GnRH-a was a protective factor for the falling off of LNG-IUS implanted under hysteroscope(OR=0.233,P<0.01).Conclusion In clinical practice,by examining the risk factors,hysteroscopic LNG-IUS falling off can be identified and corresponding interventions can be given to reduce the risk of hysteroscopic LNG-IUS falling off.

关 键 词：左炔诺孕酮宫内节育系统 宫腔镜 脱落 影响因素 

分 类 号：R169.41[医药卫生—公共卫生与预防医学]