保留子宫手术治疗子宫腺肌病的现状与进展

Current Situation and Progress of Uterus-Sparing Operative Treatment for Adenomyosis

子宫腺肌病是育龄妇女常见良性疾病,目前子宫腺肌病的根治手段仍然是经腹或经腹腔镜切除子宫。近年来随着磁共振成像(MRI)及经阴道超声(TVU)等医学影像技术的发展和普及应用,大量年轻女性子宫腺肌病被检出,越来越多的年轻育龄患者因为生活质量等多种因素,迫切希望保留子宫的完整性和生育力。因此,各种保留子宫的手术方式如腺肌病病灶切除后再成型子宫、部分腺肌病病灶切除联合子宫动脉阻断等越来越多地应用于临床,综述保留子宫的手术方式的临床应用现状及进展。

Adenomyosis is a common benign disease that usually affects women of reproductive age, which is characterized by the growth of endometrial glands and stroma into the myometrium. Hysterectomy by laparotomy or laparoscopy is currently leading therapeutics for adenomyosis, applying to women without fertility requirements. Since the development and popularization applications of magnetic resonance（MRI） and transvaginal ultrasound（TVU） as well as other medical imaging technologies, female of adenomyosis were increasingly diagnosised at younger age,leading to a shift of the clinical treatment modalities. More and more women strongly hope for the integrity of uterus and fertility because of many factors, such as quality of life. Therefore, uterus-sparing operative treatment for adenomyosis, such as adenomyomectomy and uterine remodeling, partial resection of the lesion of adenomyosis plus uterine artery occlusion, is being developed, and is discussed in detail in this review.