子宫肌瘤微无创治疗的适应证和禁忌证  

Indications and contraindications of non-invasive and minimally invasive treatment for uterine fibroids

作　　者：叶明珠[1] 薛敏[1] YE Ming-zhu;XUE Min(Department of Gynecology,the Third Xiangya Hospital of Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院妇科,湖南长沙410013

出　　处：《中国实用妇科与产科杂志》2024年第9期886-891,共6页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：湖南省自然科学基金(2021JJ31031)。

摘　　要：子宫肌瘤是最常见的妇科疾病之一,有症状的子宫肌瘤需要进行临床治疗。由于药物治疗复发率高、症状缓解程度和持续时间有限,故常用于症状轻、手术治疗前预处理及拒绝或无法手术等情况,而其他有症状的子宫肌瘤仍需选择更有效的治疗方法。为了减少治疗所导致的创伤,临床上出现了多种子宫肌瘤的微无创治疗方法,主要包括微创手术,如腹腔镜下子宫肌瘤切除术或子宫切除术、阴式子宫肌瘤切除术或子宫切除术、宫腔镜下子宫肌瘤切除术等。此外,随着新型非手术微无创治疗技术的不断发展,血管介入治疗和聚焦超声消融手术等也应用于子宫肌瘤的临床治疗。文章就目前常见的子宫肌瘤微无创治疗方法的适应证和禁忌证进行阐述及总结,从而为子宫肌瘤临床治疗的决策选择提供参考。Uterine fibroids are one of the most common gynecological diseases,and symptomatic uterine fibroids usually need clinical treatment.However,drug treatments have a high recurrence rate and offer limited relief in terms of both degree and duration of symptoms.As a result,these treatments are typically used for mild symptoms,as a pre-treatment before surgical options,or in cases where surgery is not feasible or desired.For more severe symptoms,alternative and more effective treatment methods are necessary. To minimize the trauma associated with treatments,various non-invasive and minimally invasive approaches have been developed in clinical practice.These include minimally invasive surgeries like laparoscopic myomectomy or hysterectomy,vaginal myomectomy or hysterectomy,and hysteroscopic myomectomy.In addition,with the advancements in non-surgical non-invasive and minimally invasive novel treatments,vascular interventional therapy and focused ultrasound ablation surgery have been increasingly utilized in clinical settings.This paper aims to outline the indications and contraindications of common non-invasive and minimally invasive treatment methods for uterine fibroids,providing valuable insights for clinicians in making decisions regarding the treatment of uterine fibroids.

关 键 词：子宫肌瘤 适应证 禁忌证 腹腔镜 宫腔镜 聚焦超声消融手术 子宫动脉栓塞术 

分 类 号：R711.74[医药卫生—妇产科学]