| 摘要: |
| ［摘要］ 子宫腺肌病是育龄期女性常见的良性疾病，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。该文系统综述了子宫腺肌病的诊断评估、保留生育功能手术技术及高强度聚焦超声、子宫动脉栓塞、射频消融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。通过结合疾病类型、患者特征及生育目标制订个体化策略，落实规范围手术期管理，权衡子宫破裂、胎盘植入性疾病等产科风险，有助于改善妊娠结局。 |
| 关键词: 子宫腺肌病 保留生育功能手术 高强度聚焦超声 子宫动脉栓塞 射频消融 生殖结局 |
| DOI：10.3969/j.issn.1674-3806.2026.09.03 |
| 分类号:R 711.74 |
| 基金项目:重庆市卫生健康委妇科肿瘤基础与临床转化重点实验室建设项目 |
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| Advances in fertility-sparing surgery and minimally invasive treatment for adenomyosis |
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Liang Xiaolong1, Liang Zhiqing2
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1.Department of Obstetrics and Gynecology, the Southwest Hospital of Army Medical University, Chongqing 400038, China; 2.Center for Obstetrics and Gynecology, the Third Affiliated Hospital of Chongqing Medical University, Chongqing 401120, China
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| Abstract: |
| ［Abstract］ Adenomyosis is a common benign disease in women of reproductive age, characterized pathologically by the infiltration of endometrial glands and stroma into the myometrium. For patients with fertility aspirations, the therapeutic paradigm has shifted from solely pursuing complete lesion excision to a comprehensive approach that balances lesion burden control, preservation of uterine structural integrity, and improvement of pregnancy outcomes. This review systematically summarizes current advancements in the diagnostic assessment of adenomyosis, fertility-sparing surgical techniques, and minimally invasive interventional therapies, including high-intensity focused ultrasound(HIFU), uterine artery embolization(UAE), and radiofrequency ablation(RFA), with a focus on their efficacy and safety. Special emphasis is placed on factors influencing reproductive outcomes and strategies for patient selection. Formulating individualized strategies based on disease type, patient characteristics, and fertility goals, together with standardized perioperative management and consideration of obstetric risks such as uterine rupture and placenta accreta spectrum disorders, is crucial for improving pregnancy outcomes. |
| Key words: adenomyosis fertility-sparing surgery high-intensity focused ultrasound(HIFU) uterine artery embolization(UAE) radiofrequency ablation(RFA) reproductive outcomes |
