子宫内膜异位症:终生管理与降阶梯治疗  

The Implementation of De-escalation Therapy for Inhibition and Protection of Ovarian Function in Lifetime Management of Endometriosis

作　　者：刘淑娟[1] 张潍[1] 张晓红[1] 蔡国青[1] 邹伟[1] 杨红[1] 马向东[1] 陈必良[1] 辛晓燕[1] 王建[1] 

机构地区：[1]第四军医大学西京医院妇产科,陕西西安710032

出　　处：《医学与哲学（B）》2015年第11期22-25,31,共5页Medicine & Philosophy(B)

基　　金：国家自然科学基金项目;项目编号:81172458;陕西省科技统筹创新工程基金重大项目;项目编号:2012KCTL03-08

摘　　要：子宫内膜异位症是育龄妇女的常见病,更是典型的慢性病。其发病、病情进展或复发、转归等与卵巢功能密切相关。因此,抑制或终止卵巢功能是目前治疗子宫内膜异位症最有效的手段之一。但对年轻及/或有生育要求的子宫内膜异位症患者而言,保护卵巢及生育功能是子宫内膜异位症治疗中难以回避的问题。如何有效地治疗子宫内膜异位症、控制病变活动、减少延缓复发,实现慢性病长期管理,同时保护好患者的卵巢功能及生育能力。现实的要求迫使子宫内膜异位症治疗在抑制和保护卵巢功能的左右摇摆中前行。本文提出"降阶梯治疗"概念及长期管理的策略,并就实现"长期或终生管理"理念作一简要设想和分析。Endometriosis is a chronic disease commonly found in women of childbearing age. Its pathogenesis, disease progression, relapse, and outcome are closely related with ovarian function. Hence, inhibition or termination of ovarian function is one of the most effective means in treating endometriosis. However, for the younger endometriosis patients who still want to bear children in the future, protecting the ovaries and reproductive function is a difficult problem that can＇t be avoided in the treatment of endometriosis. How to effectively treat endometriosis, control disease activity, decrease chance of recurrence, and achieve long-term management of this chronic diseases, all the while protect ovarian function and fertility needs of patients. These real demands cause endometriosis treatment to swing between the suppression and the preservation of ovarian function. This manuscript briefly discuses the concept of ＂de-escalation therapy＂ and its long-term management strategy, and analyzes the application of ＂long-term or life-long management＂.

关 键 词：子宫内膜异位症 卵巢功能保护 降阶梯治疗 终生管理 

分 类 号：R711.71[医药卫生—妇产科学]