子宫腺肌病的药物治疗及微创手术进展  

Progress in drug therapy and minimally invasive surgery for adenomyosis

作　　者：张丹妮 王荣宇 杨志强 张鸿刚 邓骁 刘迪 张术红 王丽 ZHANG Danni;WANG Rongyu;YANG Zhiqiang;ZHANG Honggang;DENG Xiao;LIU Di;ZHANG Shuhong;WANG Li(The 964th Hospital of Joint Logistics Support Force of the Chinese People's Liberation Army,Changchun 130062,China;The 32116th Unit of the Chinese People's Liberation Army,Hunchun 133300,China)

机构地区：[1]中国人民解放军联勤保障部队第九六四医院,长春130062 [2]中国人民解放军第32116部队,吉林珲春133300

出　　处：《长春中医药大学学报》2024年第9期1054-1057,共4页Journal of Changchun University of Chinese Medicine

基　　金：吉林省卫生健康科技能力提升项目(2022LC137)。

摘　　要：子宫腺肌病治疗方法多样,常用药物及微创手术各有利弊。非甾体类抗炎药是针对疼痛的对症治疗,也是妊娠期女性唯一用药。保留子宫的患者首选口服避孕药,促性腺激素释放激素可以提高妊娠机会,左炔诺孕酮宫内缓释系统可减轻症状。药物治疗有效,但是未去除病灶。宫腔镜手术适用于浅表性腺肌瘤和浅表性弥漫性腺肌病的病例,对于深部的症状性腺肌病宫腔镜切除是有争议的。腹腔镜手术可去除深部局灶性腺肌瘤和弥漫性病变,但要降低术后子宫破裂的可能性。There are various treatment methods for adenomyosis.Common drugs and minimally invasive surgery have their own advantages and disadvantages.Non-steroidal anti-inflammatory drugs are symptomatic treatments for pain and are the only medication used in pregnant women.Patients who preserve their uterus should fi rst choose oral contraceptives,and gonadotropin releasing hormone can increase the chances of pregnancy,and the levonorgestrel intrauterine sustained-release system can alleviate symptoms.Drug therapy is eff ective,but the lesion has not been removed.Hysteroscopic surgery is suitable for the cases with superfi cial adenomyoma and superfi cial diff use adenomyosis,and hysteroscopic resection for deep symptomatic adenomyosis is controversial.Laparoscopic surgery can be used to remove deep focal gonadal myoma and diff use lesions.But this therapy should pay attention to reducing the possibility of postoperative uterine rupture.

关 键 词：子宫腺肌病 非甾体类抗炎药 口服避孕药 地诺孕素 左炔诺孕酮宫内缓释系统 达那唑 促性腺激素释放激素激动剂 宫腔镜手术 腹腔镜手术 

分 类 号：R711.71[医药卫生—妇产科学]