| 摘要: |
| 子宫腺肌病是育龄期女性常见良性疾病,其病理特征为子宫内膜腺体与间质向肌层浸润。对有生育计划的患者,治疗理念已由单纯追求病灶彻底切除转向兼顾病灶负担控制、子宫结构保护与妊娠结局改善的综合目标。本文系统综述了腺肌病的诊断评估、保留生育功能手术技术及高强度聚焦超声(HIFU)、子宫动脉栓塞(UAE)、射频消融(RFA)等微创介入治疗的疗效与安全性,重点总结生殖结局的影响因素与患者选择策略。综合疾病类型、患者特征与生育目标制定个体化策略,并进行规范围手术期管理,同时充分权衡子宫破裂、胎盘植入性疾病等产科风险,有助于获得满意妊娠结局。 |
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Liang Xiaolong
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The First Affiliated Hospital（Southwest Hospital ）of Army Medical University
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| Abstract: |
| Adenomyosis is a common benign disorder in women of reproductive age, pathologically characterized by the invasion of endometrial glands and stroma into the myometrium. For patients with fertility intentions, the therapeutic concept has shifted from simply pursuing complete lesion resection to a comprehensive goal that balances lesion burden control, uterine structure preservation, and improved pregnancy outcomes. This article systematically reviews the diagnostic evaluation of adenomyosis, fertility?sparing surgical techniques, as well as the efficacy and safety of minimally invasive interventional therapies including high?intensity focused ultrasound (HIFU), uterine artery embolization (UAE), and radiofrequency ablation (RFA). It mainly summarizes influencing factors for reproductive outcomes and patient selection strategies. Formulating individualized regimens based on disease subtypes, patient profiles and fertility goals, implementing standardized perioperative management, and fully weighing obstetric risks such as uterine rupture and placenta?related invasive disorders are conducive to achieving favorable pregnancy outcomes. |
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