Modified Fixation of Levonorgestrel-releasing Intrauterine System for the Treatment of Adenomyosis

LI Jinbo; LI Xueyun; WU Fuli; CHEN Shuqin

doi:10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240314.001

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Modified Fixation of Levonorgestrel-releasing Intrauterine System for the Treatment of Adenomyosis

Clinical Research | 更新时间：2024-04-15

- Modified Fixation of Levonorgestrel-releasing Intrauterine System for the Treatment of Adenomyosis
- Journal of Sun Yat-sen University(Medical Sciences) Vol. 45, Issue 2, Pages: 290-296(2024)
- 作者机构：
  
  1.中山大学附属第六医院妇科，广东广州 510655
  2.广州市黄埔区中六生物医学创新研究院，广东广州 510655
  3.顺德区第三人民医院妇产科，广东顺德 528300
  4.中山大学附属第六医院粤西医院//信宜市人民医院妇科，广东茂名 525300
- 作者简介：
  
  CHEN Shuqin； E-mail： chshqin@mail.sysu.edu.cn
- 基金信息：
- DOI：10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240314.001
  CLC： R713.4
- Published：20 March 2024，
  
  Received：08 January 2024，
  
  Accepted：11 March 2024
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李锦波,李雪云,吴福丽等.改良式左炔诺孕酮宫内缓释系统固定治疗子宫腺肌病[J].中山大学学报（医学科学版）,2024,45(02):290-296.

LI Jinbo,LI Xueyun,WU Fuli,et al.Modified Fixation of Levonorgestrel-releasing Intrauterine System for the Treatment of Adenomyosis[J].Journal of Sun Yat-sen University(Medical Sciences),2024,45(02):290-296.
李锦波,李雪云,吴福丽等.改良式左炔诺孕酮宫内缓释系统固定治疗子宫腺肌病[J].中山大学学报（医学科学版）,2024,45(02):290-296. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240314.001.

LI Jinbo,LI Xueyun,WU Fuli,et al.Modified Fixation of Levonorgestrel-releasing Intrauterine System for the Treatment of Adenomyosis[J].Journal of Sun Yat-sen University(Medical Sciences),2024,45(02):290-296. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240314.001.

摘要

目的

介绍改良式左炔诺孕酮宫内缓释系统（LNG-IUS）固定方法，探讨其在治疗既往曾发生LNG-IUS脱落的子宫腺肌病患者中的作用。

方法

收集2022年6月至2023年6月因LNG-IUS脱落在3个医疗机构接受改良式LNG-IUS固定的22例子宫腺肌病患者的资料，分析患者的术前病例特征、术中术后并发症及术后LNG-IUS下移或脱落情况，比较术前、术后3月及术后6月患者痛经及月经量的变化。

结果

22例患者平均手术时间（19.51±7.41）min，术中出血（6.71±5.30）mL。13例患者在局部麻醉下进行，9例患者在静脉麻醉下进行。4例患者由住院医生完成，15例患者由主治医师完成，余3例由副主任及以上医师完成。所有患者未发生术中、术后并发症。平均随访时间11.51月，随访期间无患者再次发生LNG-IUS脱落。患者术后1月血红蛋白平均水平显著高于术前（

0.001）。术后3月及术后6月疼痛评分及月经失血图评分均比术前显著改善（

0.001）。

结论

改良式LNG-IUS固定是治疗既往发生LNG-IUS脱落的子宫腺肌病患者安全、有效的方法，可有效避免再次发生LNG-IUS脱落。改良式LNG-IUS固定操作简便，可在各级医疗机构中由各级医师施行，具有临床推广价值。

Abstract

Objective

To introduce a fixation technique with the modified levonorgestrel-releasing intrauterine system （LNG-IUS） and evaluate its efficacy in the treatment of adenomyosis patients with previous LNG-IUS expulsion.

Methods

A retrospective analysis was done on 22 adenomyosis patients who underwent modified LNG-IUS fixation due to LNG-IUS expulsion at three hospitals from June 2022 to June 2023. The baseline clinical characteristics， operative and postoperative details were collected and analyzed. The Visual analogu scale （VAS） scores and pictorial blood loss assessment chart （PBAC） scores were measured and compared before， 3 and 6 months after the LNG-IUS fixation.

Results

The mean operative time was （19.51±7.41） min and intraoperative bleeding was （6.71±5.30） mL. Of the patients， 13 were operated under local anaesthesia and the other 9 under intravenous anaesthesia. There were 4 operations performed by a resident doctor， 15 by an attending doctor and 3 by a senior doctor. No intraoperative or postoperative complication was found. The mean follow-up was 11.51 months and no patient had a recurrence of LNG-IUS expulsion during the follow-up period. The mean level of hemoglobin at 1 month after operation was significantly higher than that before （

0.001）. VAS scores and PBAC scores at 3 and 6 months postoperatively were all improved significantly than those preoperatively （

0.001）.

Conclusions

Effectively preventing the recurrence of LNG-IUS expulsion， modified LNG-IUS fixation is a safe and efficient method for adenomyosis patients with previous LNG-IUS expulsion. Modified LNG-IUS fixation deserves the clinical application due to its easy operation and wide range of use on women.

关键词

左炔诺孕酮宫内缓释系统子宫腺肌病改良式固定月经过多痛经

Keywords

levonorgestrel-releasing intrauterine system （LNG-IUS）adenomyosismodified fixationmenorrhagiadysmenorrhea

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Related Author

LI Jinbo

LI Xueyun

WU Fuli

CHEN Shuqin

Related Institution

Department of Gynecology， The Sixth Affiliated Hospital， Sun Yat-sen University

Biomedical Innovation Center， The Sixth Affiliated Hospital， Sun Yat-sen University

Department of Gynecology and Obstetrics， The Third People's Hospital of Shunde District

Department of Gynecology， Yuexi Hospital of the Sixth Affiliated Hospital， Sun Yat-sen University //Xinyi People's Hospital

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