宫腔镜下缝合固定左炔诺孕酮宫内节育系统的临床分析  

Clinical analysis of hysteroscopic suture fixation of the levonorgestrel-releasing intrauterine system

作　　者：杨士荣 姜海珍 金艳艳 刘迎 杨林青[1] Yang Shirong;Jiang Haizhen;Jin Yanyan;Liu Ying;Yang Linqing(Department of Gynecology,Affiliated Hospital of Jining Medical University,Jining Shandong 272100,P.R.China)

机构地区：[1]济宁医学院附属医院妇科,山东济宁272100

出　　处：《中国计划生育和妇产科》2025年第2期73-76,共4页Chinese Journal of Family Planning & Gynecotokology

基　　金：山东省医药卫生科技项目(项目编号:202305010415);济宁医学院附属医院“苗圃”科研计划项目(项目编号:MP-ZD-2023-05)。

摘　　要：目的探讨宫腔镜下左炔诺孕酮宫内节育器系统(levonorgestrel-releasing intrauterine system,LNGIUS)缝合固定术的可行性、安全性及有效性。方法回顾性分析2022年6月至2023年10月于济宁医学院附属医院妇科接受宫腔镜下LNG-IUS缝合固定术的32例患者的临床资料。分析手术、术后相关指标,主要观察LNG-IUS脱落/下移率,分析手术治疗效果,并观察术后不良反应。结果所有患者中31例顺利完成手术、1例缝合固定失败。手术时间平均(47.3±18.2)min,术中出血平均(9.0±3.9)mL。所有患者均未出现手术并发症。术后1月、3月、6月、12月门诊复查,子宫体积、血红蛋白、痛经、月经量均较术前明显改善,差异有统计学意义(P<0.001)。至随访终点,LNG-IUS均未发生脱落,1例下移。术后不良反应少且均可以接受,患者满意度高。结论宫腔镜下LNG-IUS缝合固定术治疗可以有效预防LNG-IUS的脱落/下移,是一种安全、有效的治疗方式。Objective To investigate the feasibility,safety and efficacy of hysteroscopic suture fixation of levonorgestrelreleasing intrauterine system(LNG-IUS).Methods A retrospective analysis was performed on the clinical data of 32 patients who received the hysteroscopic suture fixation of LNG-IUS in the Department of Gynecology,Affiliated Hospital of Jining Medical University from June 2022 to October 2023.Relevant indicators of surgical and postoperative were analyzed,the main observation was the LNGIUS expulsion/downward rate,the effect of operation was analyzed and the adverse reactions were observed.Results Of all the patients,31 successfully completed the operation,and 1 failed suture fixation.The average operation time was(47.3±18.2)min,and the average intraoperative bleeding was(9.0±3.9)mL.No surgical complications occurred in all patients.Outpatient follow-up in 1 month,3 months,6 months,12 months after surgery,the uterine volume,hemoglobin,dysmenorrhea and menstrual volume were significantly improved compared to preoperative period,the difference was statistically significant(P<0.001).By the end of followup,none of the LNG-IUS was expulsed,1 case downward.Postoperative adverse reactions were few and acceptable,and patients satisfaction was high.Conclusion Hysteroscopic suture fixation of ING-IUS can effectively prevent LNG-IUS expulsion/downward,it is a safe and effective treatment.

关 键 词：左炔诺孕酮宫内节育系统 子宫腺肌病 异常子宫出血 缝合固定 

分 类 号：R711.74[医药卫生—妇产科学]