国际妇产科学杂志 ›› 2014, Vol. 41 ›› Issue (5): 562-565.

• 综述 • 上一篇    下一篇

子宫腺肌病的保守治疗

葛军,韩耀伟,周莉君   

  1. 300451 天津市滨海新区塘沽妇幼保健院妇产科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2014-10-15 发布日期:2014-10-15

Conservative Treatment of Adenomyosis

GE Jun,HAN Yao-wei,ZHOU Li-jun   

  1. Department of Obstetrics and Gynecology,Tanggu Maternity and Children Health Care Hospital of Binhai New District,Tianjin 300451,China
  • Received:1900-01-01 Revised:1900-01-01 Published:2014-10-15 Online:2014-10-15

摘要: 近年来,子宫腺肌病的发病率有逐年上升趋势,临床表现具有多样化的特点。该病治疗方法包括高强度聚焦超声治疗、药物治疗、子宫切除手术、子宫动脉栓塞治疗、放置左炔诺孕酮宫内缓释系统(LNG-IUS,商品名:曼月乐)、子宫内膜剥除术等。药物治疗近期效果明显,但是停药后易复发;切除子宫往往导致患者丧失生育能力;子宫动脉栓塞治疗操作难度大,影响疗效因素多;放置LNG-IUS具有不用手术、患者依从性好的优点,但是有部分患者会有点滴出血等问题;子宫内膜剥除术效果肯定,但是不良反应相对较多,因此各种治疗方法均存在一定局限性。随着患者对保留子宫的期望值越来越高,临床应用的很多治疗子宫腺肌病的保守方法,已经成为目前临床医生普遍关心的问题。综述子宫腺肌病的保守治疗。

关键词: 子宫内膜异位症, 栓塞, 治疗性, 超声疗法, 药物疗法, 左炔诺孕酮

Abstract: In recent years, the incidence of adenomyosis has shown a rising trend year by year and diversified clinical manifestations have been observed. Treatments for adenomyosis include high intensity focused ultrasound drug therapy, hysterectomy, uterine artery embolization, levonorgestrel releasing intrauterine system (LNG-IUS), endometrial stripping technique, etc. Recently, the effect of drug treatment is obvious, but it is easy to relapse after drug withdrawal. Removal of the uterus often leads to the loss of fertility. Uterine artery embolization is difficult to operate with a lot of factors influencing the curative effect; LNG-IUS had the characteristics of surgery-free and good compliance, but some patients may have the problems such as bleeding, etc.; Endometrial stripping operation has confirmable effect, but the side effect is also relatively bigger; therefore, various treatment methods all have some limitations. The conservative method to be employed in women with adenomyosis has become the topic that clinicians generally care about. With the increasingly high expectation of patients on saving their uterus, there have been many cases of conservative method for adenomyosis in clinical practices. Review on the conservative treatment methods of adenomyosis.

Key words: Endometriosis, Embolization, therapeutic, Ultrasonic therapy, Drug therapy, Levonorgestrel