子宫腺肌病患者保存生育力手术的难点和焦点及其手术指征探讨

Difficulties,focal points and surgical indications of fertility-sparing surgery for patients with adenomyosis

近年来,子宫腺肌病患者的生育力低下备受关注,主要包括不孕、流产、早产、死产、胎儿生长受限、子痫前期以及剖宫产率增加等。目前,子宫腺肌病不孕患者在药物、高强度聚焦超声等非手术保守性治疗失败后,往往求助于子宫腺肌病保守性手术病灶切除,但切除后的临床妊娠成功率与并发症目前一直存在争论。本文就目前子宫腺肌病患者保护生育力手术的难点与焦点以及手术指征进行探讨,以期为临床子宫腺肌病不孕患者的治疗提供参考。

Recently,the sub-fertility of patients with adenomyosis,including infertility,abortion,premature delivery,stillbirth,fetal growth restriction,preeclampsia and the increase rate of cesarean section,has attracted much attention.Currently,adenomyomectomy is the priority option to treat adenomyosis patients with infertility following the failure of non-surgical conservative treatment of adenomyosis patients with infertility,such as medical therapy and high-intensity focused ultrasound.However,the clinical pregnancy success rate and complications after conservative surgical surgery for adenomyosis patients with infertility have always been controversial.Here,the difficulties,focal points and surgical indications of fertility-sparing surgery for patients with adenomyosis are put under the microscope,so as to provide reference for the treatment of adenomyosis patients with infertility.