| 摘要: |
| 子宫腺肌病是严重影响育龄期女性生活质量常见的妇科良性疾病,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的异常增强,导致传统方法LNG-IUS置入后脱落率显著增高。据报道,在子宫腺肌病患者中,放置LNG-IU一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。本文总结盘点了针对子宫腺肌病患者LNG-IUS宫内固定术的主要方法,包括缝合固定法、吉-曼组合环固定法和盘扣悬挂法等,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,旨在为临床医生选择固定方案提供有益的参考。 |
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sunyilin1,2,3, caoying, zhengyafeng, weiweiwei
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1.Changzhou Second People'2.'3.s Hospital, The Third Affiliated Hospital of Nanjing Medical University
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| 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 as the first-line conservative treatment for adenomyosis due to its convenient placement 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 risk of LNG-IUS expulsion after conventional insertion. According to reports, the spontaneous expulsion rate of LNG-IUS in patients with adenomyosis within one year of placement is as high as 10%–25%. To address this challenge, various intrauterine LNG-IUS fixation techniques have been explored in clinical practice. This article reviews the main methods of intrauterine LNG-IUS fixation for patients with adenomyosis, including suture fixation, the GyneFix-assisted Mirena combination ring fixation and button-anchoring fixation. It focuses on summarizing the specific procedures, technical advantages, limitations, and challenges of each technique, aiming to provide a useful reference for clinicians in selecting appropriate fixation strategies. |
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