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子宫腺肌病是指子宫肌层内存在子宫内膜腺体和间质,在激素的影响下发生出血,肌纤维结缔组织增生,形成弥漫病变或局限性病变,痛经和月经量增多为主要表现。对于年轻或有生育要求的患者可选择药物治疗,临床常用药物有雄激素类衍生物、促性腺激素释放激素激动剂、米非司酮、左旋18甲基炔诺酮(曼月乐)。手术治疗包括根治手术和根治保守手术。根治术即为子宫切除术,无生育要求且病变广泛、症状重、保守治疗无效者可选全子宫切除术。痛经症状突出者可行保守手术,包括子宫腺肌病病灶(腺肌瘤)切除术、子宫内膜及肌层切除术、腹腔镜下子宫肌层电凝术,腹腔镜子宫神经去除术和骶前神经阻断术。子宫动脉栓塞术和腹腔镜下子宫动脉阻断术也越来越多的应用到子宫腺肌病的治疗。
Adenomyosis refers to the presence of endometrial glands and interstitium in the myometrium, bleeding under the influence of hormones, proliferation of muscle fiber connective tissue, the formation of diffuse lesions or localized lesions, dysmenorrhea and increased menstrual flow as the main performance. For young or reproductive patients can choose the drug treatment, commonly used drugs in clinical androgen derivatives, gonadotropin-releasing hormone agonist, mifepristone, levonorgestrel 18 (norepinephrine). Surgical treatment includes radical surgery and radical conservative surgery. Radical surgery is the hysterectomy, no reproductive requirements and extensive lesions, symptoms, conservative treatment ineffective optional hysterectomy. Dysmenorrhea symptoms may be conservative surgery, including adenomyosis (adenomyosis) adenomyosis, endometrial and myomectomy, laparoscopic myometrial electrocoagulation, laparoscopic uterine nerve removal and presacral Nerve block. Uterine artery embolization and laparoscopic uterine artery occlusion is also more and more applied to the treatment of adenomyosis.