| 摘要: |
| ［摘要］ 子宫腺肌病是严重影响育龄期女性生活质量的常见妇科良性疾病，左炔诺孕酮宫内缓释系统（LNG-IUS）因其放置方便，可有效缓解痛经、减少月经量，是临床指南推荐的子宫腺肌病保守治疗的首选方案。然而，由于子宫腺肌病患者常伴有子宫体积增大、宫腔形态失常及子宫肌壁蠕动异常增强，导致传统方法放置LNG-IUS后脱落率显著增高。据报道，在子宫腺肌病患者中，放置LNG-IUS后1年内的自然脱落率高达10%～25%。为解决这一难题，临床上探索了多种宫内LNG-IUS固定技术。该文总结盘点了针对子宫腺肌病患者LNG-IUS宫内固定的主要方法，包括缝合固定法、吉-曼组合环固定法和免缝合盘扣悬挂法等，重点总结各类术式的具体操作方法、技术优势、局限性与挑战，旨在为临床医师选择固定方案提供参考。 |
| 关键词: 子宫腺肌病 左炔诺孕酮宫内缓释系统 宫内固定术 |
| DOI：10.3969/j.issn.1674-3806.2026.09.07 |
| 分类号:R 711.74 |
| 基金项目:南京医科大学2023年度教育研究课题（编号：2023ZC088）；常州市“十四五”卫生健康高层次人才培养工程；常州市卫生健康委科技项目重大项目（编号：ZD202314） |
|
| An overview of intrauterine fixation techniques for levonorgestrel-releasing intrauterine system in treatment of adenomyosis |
|
Sun Yilin, Wei Weiwei, Cao Ying, Zheng Yafeng, Chen Jiming
|
|
Department of Gynecology, the Second People′s Hospital of Changzhou, the Third Affiliated Hospital of Nanjing Medical University, Changzhou 213000, China
|
| Abstract: |
| ［Abstract］ Adenomyosis is a common benign gynecological condition that severely affects the quality of life in women of reproductive age. The levonorgestrel-releasing intrauterine system(LNG-IUS) is recommended by clinical guidelines as the first-line conservative treatment for adenomyosis due to its ease of insertion and effectiveness in alleviating dysmenorrhea and reducing menstrual blood loss. However, patients with adenomyosis often present with an enlarged uterine volume, distorted uterine cavity morphology, and abnormally enhanced myometrial contractility, which significantly increase the rate of LNG-IUS expulsion after its conventional insertion. According to reports, the spontaneous expulsion rates of LNG-IUS in adenomyosis patients within one year of its insertion range from 10% to 25%. To address this challenge, various intrauterine fixation techniques for LNG-IUS have been explored in clinical practice. This paper summarizes the main methods of intrauterine LNG-IUS fixations for patients with adenomyosis, including suture fixation, the GyneFix-assisted Mirena combination ring fixation and non-suture fixation. It focuses on summarizing the specific procedures, technical advantages, limitations, and challenges associated with each technique, aiming to provide reference for clinicians in selecting appropriate fixation strategies. |
| Key words: adenomyosis levonorgestrel-releasing intrauterine system(LNG-IUS) intrauterine fixation techniques |
