有生育要求子宫腺肌症的保守治疗
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摘要
子宫腺肌症(adenomyosis,Am)是指子宫内膜(包括腺体及间质)侵入子宫肌层生长而产生的良性病变,好发于30～50岁育龄期妇女,其症状主要为痛经和月经异常(多为月经量增多)。对于有症状的患者,根据患者的年龄、生理及心理需求的不同而有多种诊疗方案,大体分为手术治疗及保守治疗。对于有生育要求的Am患者,推荐手术切除病灶联合药物补充治疗的方案。
Adenomyosis refers to the benign lesions produced by the infiltration of the endometrium(including glands and interstitium) into the myometrium. It occurs in women of childbearing age of 30 to 50 years old. The symptoms are mainly dysmenorrhea and menstrual abnormalities(mostly Increased menstrual flow). For symptomatic patients, there are a variety of treatment options depending on the age, physical and psychological needs of the patient, which are roughly classified into surgical treatment and conservative treatment. For young patients with adenomyosis and fertility requirements, conservative treatment can be used to relieve symptoms, a surgical resection of the lesion combined with drug replacement therapy is recommended.
Adenomyosis refers to the benign lesions produced by the infiltration of the endometrium(including glands and interstitium) into the myometrium. It occurs in women of childbearing age of 30 to 50 years old. The symptoms are mainly dysmenorrhea and menstrual abnormalities(mostly Increased menstrual flow). For symptomatic patients, there are a variety of treatment options depending on the age, physical and psychological needs of the patient, which are roughly classified into surgical treatment and conservative treatment. For young patients with adenomyosis and fertility requirements, conservative treatment can be used to relieve symptoms, a surgical resection of the lesion combined with drug replacement therapy is recommended.
引文
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5 .Benagiano G, Habiba M, Brosens I. The pathophysiology of uterine adenomyosis:an update[J]. Fertil Steril, 2012, 98(3):572-579.
6 .沈铿,马丁.妇产科学[M]. 3版.北京:人民卫生出版社, 2015.SHEN Keng, MA Ding. Obstetrics and gynecology[M]. 3rd ed. Beijng:People’s Health Publishing House, 2015.
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8 .Alv iFA,GlaserLM,ChaudhariA,etal.Newparadigmsin theconser vativesurgicalandinter ventionalmanagementof adenomyosis[J]. Curr Opin Obstet Gynecol, 2017, 29(4):240-248.
9 .deBruijnAM,SminkM,HehenkampWJK,etal.Uterineartery embolization for symptomatic adenomyosis:7-year clinical follow-up using UFS-Qol questionnaire[J]. Cardiovasc Intervent Radiol, 2017,40(9):1344-1350.
10 .杨亚培,王武亮,冯广森.超选择性子宫动脉栓塞术治疗子宫腺肌病痛经68例分析[J].中国实用妇科与产科杂志, 2012(7):530-532.YANGYapei,WANGWuliang,FENGGuangsen.Theclinical curative effect of super selective uterine artery embolization to ease the dysmenorrhea of adenomyosis[J]. Chinese Journal of Practical Gynecology and Obstetrics, 2012(7):530-532.
11 .de Bruijn AM, Smink M, Lohle PNM, et al. Uterine artery embolization forthetreatmentofadenomyosis:asystematicreviewandmetaanalysis[J]. J Vasc Interv Radiol, 2017, 28(12):1629-1642.e1.
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13 .崔杰,许永华,田绍创,等.影响聚焦超声治疗子宫腺肌病消融率的相关因素初步分析[J].中华临床医师杂志(电子版), 2015,9(10):82-85.CUI Jie, XU Yonghua, TIAN Shaochuang, et al. Analysis of the factors influencing the ablation rate of adenomyosis by using high intensity focusedultrasound[J].ChineseJournalofClinicians.Electronic Edition, 2015, 9(10):82-85.
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