两种新型LNG-IUS固定术治疗子宫腺肌病的病例报告及比较分析

Case reports and comparative analysis of two novel LNG-IUS fixation techniques for the treatment of adenomyosis

目的探讨两种新型LNG-IUS固定术治疗子宫腺肌病的疗效及安全性。方法回顾性分析广东省妇幼保健院2021年10月至2022年7月收治的34例子宫腺肌病患者的临床资料。比较吉曼组(23例)和缝合组(11例)手术及术后相关指标、术后子宫腺肌病症状(痛经、月经量多)改善情况、不良结局发生情况(节育器下移、脱落)。结果两组的年龄、病程、症状、既往治疗情况差异无统计学意义(P>0.05)。两组患者术后VAS评分、PBAC评分、CA125水平及子宫体积均较术前明显下降,血红蛋白值均较术前明显升高,差异均有统计学意义(P<0.05)。吉曼组的手术时长、住院时长、术中出血量及麻醉率均低于缝合组,差异均有统计学意义(P<0.05)。结论两种新型LNG-IUS固定术对于既往曾发生过曼月乐脱落的子宫腺肌病患者的痛经、月经过多、子宫增大均有较好的治疗效果,吉曼宫腔内放置术与宫腔镜下LNG-IUS缝合固定术相比,具有操作简单、无需特殊设备和器械、手术创伤小、手术时间短、出血少、恢复快、取出方便的优点。

Objective To investigate the efficacy and safety of two novel LNG-IUS fixation techniques in the treatment of adenomyosis.Methods A retrospective analysis was performed on the clinical data of 34 patients with adenomyosis admitted to Guangdong Maternal and Child Health Hospital from October 2021 to July 2022.The surgical and postoperative indicators,improvement of adenomyosis symptoms(dysmenorrhea,menorrhagia)and occurrence of adverse events(IUD migration,expulsion)were compared between the GyneMi group(23 cases)and the suturing group(11 cases).Results There were no statistically significant differences in age,course of disease,symptoms and previous treatment between the two groups(P>0.05).After surgery,the VAS score,PBAC score,CA125 level and uterine volume of both groups significantly decreased,while the hemoglobin level significantly increased,the differences were statistically significant(P<0.05).The surgical duration,hospital stay,intraoperative blood loss,and anesthesia rate in the GyneMi group were lower than those in the suturing group,the differences were statistically significant(P<0.05).Conclusion Both novel LNG-IUS fixation techniques have good therapeutic effects on dysmenorrhea,menorrhagia and uterine enlargement in patients with adenomyosis who had suffered from the exfoliation of Menyuela in the past.Compared with the hysteroscopic LNG-IUS suturing fixation technique,the GyneMi intrauterine device fixation technique has the advantages of simple operation,no need for special equipment or instruments,less surgical trauma,shorter operation time,less bleeding,faster recovery,and easier removal.