子宫腺肌病保守性手术的应用及研究进展

Application and Research Progress of Conservative Surgery for Adenomyosis

子宫腺肌病的主要症状为继发性进行性加重的痛经,可伴有月经量过多或经期延长,严重影响患者的生活质量。手术为子宫腺肌病的重要治疗方法。由于越来越多的年轻患者要求保留生育能力,因此子宫腺肌病的保守性手术应运而生。目前子宫腺肌病的保守性手术主要包括:"三叶瓣"式病灶及肌层切除术、不对称性纵向病灶及肌层切除术、单纯病灶切除术、病灶切除术联合子宫动脉阻断术或子宫神经去除术、宫腔镜下子宫内膜及肌层切除术、子宫体楔形切除术等。手术方式的选择应根据患者的年龄、症状、有无生育要求、病变部位及范围决定。

The main symptoms of adenomyosis are progressively secondary dysmenorrhoea and may be associated with hypermenorrhoea or menostaxis,affecting the quality of patients′normal life seriously. Surgical treatment for adenomyosis is of great importance. As more and more young patients desire to preserve their fertility ,therefore,the conservative surgery emerged. At present,conservative surgical managements are composed of the triple-flap method ,asymmetric longitudinal dissection of the uterus,excisional surgery,excisional surgery united with uterine artery ligated or uterine nerve ablation,hysteroscopic ablation and excision,wedge-shaped resection and so on. Choice of surgical procedure should be based on patients′age,symptoms,with or without fertility requirements,and the scope of the lesion decision.