子宫腺肌瘤术后保守治疗的研究进展

The research progress on conservative treatment after the operation of uterine adenomyoma

子宫内膜腺体和间质存在于子宫肌层,形成结节或肿块,如肌瘤,称为子宫腺肌瘤。它是一种常见的良性妇科疾病。总的发病率从8%~57%不等^([1])。主要表现为月经过多、进行性痛经、不孕、子宫增大等。严重影响妇女的身心健康和生活质量。子宫腺肌瘤的发病机制尚不清楚。由于它在分娩妇女中更为常见,一般认为它与分娩、妊娠、刮宫和人工流产密切相关,而且也是性激素依赖性疾病。由于其缺乏特效药物治疗,除子宫切除术外,尚无根治的方法。对年轻子宫腺肌瘤或者不愿意切除子宫患者可行规范的保留子宫手术,可明显改善症状,但是因病灶与正常组织界限不清,术后容易复发。为临床常见难治病之一,一直受到人们的关注。目前子宫腺肌瘤术后保守药物治疗方法及其他保守治疗方法现综述如下。

A few adenomyosis lesions grow to form nodules or masses,such as intramural myoma,called uterine adenomyoma.It is a common benign disease of gynecology.The total incidence rate varies from 8%to 57%[1].The main manifestations are progressive dysmenorrhea,excessive menstruation,uterine enlargement and infertility,which seriously affect the physical and mental health of women and the quality of life.The pathogenesis of adenomyoma is still not very clear.It is more common in parous women,generally with pregnancy,abortion,curettage and delivery are closely related,but also a kind of sex hormone dependent diseases.There is no radical cure in addition to hysterectomy because of its lack of special drug treatment.Adenomyoma has a trend of younger generation in recent years.For young patients,the operation of the uterus and the reproductive function should be performed.The excision of focal adenomyoma of the focal uterine leiomyoma is not clear because of the lesion and normal tissue,and it is easy to recur after operation.People have been paying attention to one of the common refractory diseases in the clinic.At present,the methods of conservative medicine treatment and other conservativetreatment of adenomyoma after operation are summarized as follows.