周江妍 陈丽娟 徐黎贤 刘魏 陈建平

[摘要] 目的 評价左炔诺孕酮宫内缓释系统治疗剖宫产术后子宫切口憩室的有效性。 方法 收集2018年1月至2020年6月我院妇科门诊收治的子宫切口憩室患者60例，根据患者意愿入组，接受左炔诺孕酮宫内缓释系统治疗患者为观察组，接受优思悦药物治疗患者为对照组。观察两组不同时间段月经周期、经期、经量变化。 结果 观察组治疗6、12个月有效率为84.38%、93.75%，对照组治疗6、12个月有效率为60.71%、75.00%，差异有统计学意义（P<0.05）;观察组6、12个月时平均经期时长为（2.04±1.01）d、（1.49±2.01）d，对照组为（3.15±2.11）d、（3.00±2.16）d，差异有统计学意义（P<0.05）。 结论 左炔诺孕酮宫内缓释系统治疗子宫切口憩室患者，可有效缩短经期，提高生活质量，值得推广。

[关键词] 左炔诺孕酮宫内缓释系统;剖宫产术后;子宫切口憩室;有效性

[中图分类号] R713.4          [文献标识码] B          [文章编号] 1673-9701（2021）36-0068-03

Clinical analysis on levonorgestrel-releasing intrauterine system in the treatment of uterine incision diverticulum after cesarean section

ZHOU Jiangyan1   CHEN Lijuan2   XU Lixian1   LIU Wei1   CHEN Jianping1

1.Department of Gynecology， Jiangxi Maternal and Child Health Hospital，Nanchang   330000， China;2.Department of Gynecology， Fengcheng Maternal and Child Health Hospital in Jiangxi Province，Fengcheng   331100， China

[Abstract] Objective To evaluate the effectiveness of levonorgestrel-releasing intrauterine system （LNG？IUS） in the treatment of uterine incision diverticulum after cesarean section. Methods A total of 60 patients with uterine incision diverticulum admitted to the gynecology outpatient clinic of our hospital from January 2018 to June 2020 were selected as the study subjects. According to patients′ willingness for medication， those treated with LNG-IUS were selected as the observation group， while those treated with yasmin were selected as the control group. The changes of menstrual cycle， menstrual period and menstrual volume at different periods of two groups were observed. Results The effective rates at 6 and 12 months of treatment in the observation group were 84.38% and 93.75%， while those in the control group were 60.71% and 75%， with statistically significant differences（P<0.05）.The average lengths of menstruation at 6 and 12 months of treatment in the observation group were （2.04±1.01）d and （1.49±2.01）d， while those in the control group were （3.15±2.11） d and （3.00±2.16） d， with statistically significant differences（P<0.05）. Conclusion In the treatment of patients with uterine incision diverticulum， LNG-IUS can effectively shorten the menstrual period and improve the quality of life， which is worthy of promotion.

[Key words] Levonorgestrel-releasing intrauterine system; After cesarean section; Uterine incision diverticulum; Effectiveness

剖宫产术后子宫切口憩室（Previous cesarean scar diverticulum，PCSD）是指子宫下段剖宫产切口由于愈合缺陷或不良而出现的与宫腔相通的一个突向浆膜层的凹陷，其发病率约为7%[1-2]。临床表现为异常子宫出血、经期延长、淋漓不尽，月经间期点滴出血及性交后出血、痛经、慢性盆腔痛、不孕等，严重影响患者的生活质量[3]。目前，PCSD的治疗有药物治疗和手术治疗。手术治疗创伤大，费用高，且术后存在症状未改善或再次妊娠发生子宫破裂的风险[4-5]。药物治疗虽然有效但患者依从性低，停药后症状复发，有乳房疼痛、水肿、恶心等不良反应[6-7]。当前PCSD仍缺乏理想的治疗方式，本研究应用左炔诺孕酮宫内缓释系……