践行患者受益的基本原则——从累及泌尿生殖系统复杂子宫内膜异位症临床处置谈起

Practice the Basic Principle of " Patient Benefit" :a discussion from the clinical management of endometriosis involving the urinary and reproductive system complex

"患者受益"作为临床处置决策的基本原则在日常的医疗工作中发挥着积极的作用。同样也在常见类型子宫内膜异位症(EM)诊疗过程中得到很好地贯彻执行。然而,对于少见的累及泌尿系的EM,由于缺乏可靠的临床循证医学证据用以指导患者具体的临床处理,把握患者利益最大化原则就显得尤为重要。怎样掌握累及泌尿生殖系子宫内膜异位症患者临床处置决策中的关键要素,尽可能为患者保留生殖能力与泌尿系统的完整性,以提高日后的生活质量。除需要详细了解患者病史特别是手术史、盆腔影像学检查、肾脏功能评估结果外,选择个性化的干预手段并对预后进行综合评估,制定最为适合的治疗方案是至关重要的。本文结合临床典型病例就此问题做一剖析。

The basic principle of ＂patients benefit＂ in clinical treatment decisions has a positive effect in daily medical work, and was also implemented nicely in the treatment process of common types of endometriosis （EM）. Similarly, due to a lack of reliable clinical evidence of evidence-based medicine to guide clinical treatment, maximizing ＂patients benefit＂ is especially important for rare cases of cumulative urinary tract EM. How to grasp the key factors of clinical management decisions in patients with EM which ir^volves the urinary tract, to retain as much integrity as possible of the reproductive and urinary system for patients, in order to improve the future quality of life. In addition to a detailed understanding of patient history, especially a history of pelvic operation, imaging examination, and renal function assessment results, how to choose personalized interventions and evaluate prognosis, important. This manuscript analyzes this issue using typical and to develop the most suitable treatment plan is uttermost clinical cases.