子宫腺肌病及其保守性手术治疗

摘要：子宫腺肌病（adenomyosis,AM）多发生于30～50岁之间的妇女，造成严重的痛经、慢性盆腔痛、经量增多及不孕等，严重影响患者的生存质量。子宫切除术是根治性的治疗方法。保守性手术治疗包括子宫腺肌瘤楔形切除术及宫腔镜子宫内膜及子宫腺肌病病灶电切术的局部病灶切除和子宫动脉结扎术、腹腔镜子宫骶神经切断术、骶前神经切断术。恰当的手术方式应根据患者的年龄、症状、有无生育要求、病变部位及范围而决定。多种治疗方式相结合，对于提高手术疗效、缓解症状有重要的作用。 

Conservative surgical management for uterine adenomyasis

Abstract： Adenomyosis,usually in women in their late fourth and fifth decades. It causes severe dysmenorrhea,chronic pelvic pain,increased menstrual volume,and infertility,which all seriously interfere with patients’ quality of life. For decades,hysterectomy was the only therapeutic option available to women with adenomyosis. The last two decades witness a considerable accumulation of information on therapeutic options other than hysterectomy for adenomyosis. Conservative surgeries include myometrial excision,endometrial ablation/resection via hysteroscopy,uterine artery ligation,laparoscopic uterosacral nerve ablation and presacral neurectomy,are at the surgeon's disposal. Patient's age and symptoms,desired fertility,site and extent of lesion and surgeon’s skills should be considered in choosing the appropriate procedure. Various therapeutic options for adenomyosis,combination of procedures becomes available in the last decades and need evaluation and improvement.