子宫腺肌病的诊治进展

子宫腺肌病（adenomyosis，AD）是一种良性子宫疾病，其特征是子宫肌层中存在异位子宫内膜腺体和基质。该病发病机制仍不明确，其好发于30～50岁育龄期妇女，临床常表现为无症状、下腹疼痛、异常子宫出血。经阴道超声及磁共振成像有助于AD诊断，尽管诊断方法有所改进，该病缺乏统一分类，患者对病情的认识仍不足。目前该病的药物治疗方法有促性腺激素释放激素激动剂、左炔诺孕酮宫内缓释系统；保守手术治疗方法有子宫动脉栓塞、病灶切除术、高强度聚焦超声。研究表明AD对女性生育能力有负面影响，并且具有流产和产科并发症的高风险，AD治疗后可以提高不孕患者的生育能力，需要制定AD终生管理计划。

Diagnosis and Treatment of Adenomyosis

Adenomyosis (AD) as a benign uterine disease is characterized by ectopic endometrial glands and stroma in the myometrium. The pathomechanism of AD is still unclear. This disease often occurs in women of childbearing age from 30 to 50 years old. Clinical manifestations may be asymptomatic, hypogastralgia or abnormal uterine bleeding. Transvaginal ultrasound and magnetic resonance imaging are helpful in the diagnosis of AD. Although diagnostic methods have been improved, there is not a uniform classification of AD. The patients′ understanding is still insufficient. Currently, the therapy drug for this disease includes gonadotropin-releasing hormone agonist and levonorgestrel intrauterine sustained release system. The conservative surgery includes uterine artery embolization, lesion resection and high intensity focused ultrasound. Studies have shown that AD has a negative impact on female fertility, with high risks of miscarriage and obstetric complications. After the effective treatment, the fertility can be improved. It is necessary to develop a lifelong health management plan for those AD patients.