| 摘要: |
| ［摘要］ 子宫腺肌病是妇科常见的良性疾病，可导致痛经、月经过多、慢性盆腔痛及不孕等问题。传统子宫切除术疗效确切，但难以满足年轻患者及有保留子宫、生育需求患者的治疗需求。近年来，高强度聚焦超声（HIFU）、射频消融（RFA）和微波消融（MWA）等热消融技术逐渐应用于子宫腺肌病治疗，为保留子宫治疗提供了新的选择。现有研究表明，影像引导热消融能够有效改善痛经和月经过多，缩小病灶及子宫体积，并在部分患者中获得良好的生育结局，然而子宫腺肌病病灶缺乏明确边界，与正常肌层呈浸润性交错分布，其治疗不仅需要关注症状改善，还应兼顾重要结构保护、生育需求及长期疾病管理。该文围绕热消融技术特点、临床决策、症状控制、生育力保护、联合治疗及安全性等方面进行综述，为子宫腺肌病热消融治疗的临床实践提供参考。 |
| 关键词: 子宫腺肌病 热消融 高强度聚焦超声 射频消融 微波消融 |
| DOI：10.3969/j.issn.1674-3806.2026.09.04 |
| 分类号:R 711.74 |
| 基金项目: |
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| Clinical strategies and research progress in thermal ablation therapy for adenomyosis |
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Zhao Xiaokang1, Feng Xiao2, Gong Xiaoming1
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1.Department of Gynecology, Hebei Maternity Hospital, Shijiazhuang 050051, China; 2.Department of Gynecology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
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| Abstract: |
| ［Abstract］ Adenomyosis is a common benign gynecological disease that can lead to dysmenorrhea, menorrhagia, chronic pelvic pain, and infertility. Although traditional hysterectomy provides definitive symptom relief, it fails to meet the treatment needs of young patients and those with a desire to preserve the uterus or maintain fertility.In recent years, thermal ablation technologies such as high-intensity focused ultrasound(HIFU), radiofrequency ablation(RFA), and microwave ablation(MWA) have gradually been applied to the treatment of adenomyosis, providing new options for uterus-sparing therapy. Existing studies indicate that image-guided thermal ablation can effectively alleviate dysmenorrhea and menorrhagia, reduce lesion size and uterine volume, and achieve favorable reproductive outcomes in some patients. However, adenomyotic lesions lack clear boundaries and exhibit an infiltrative interdigitation with normal myometrium. Therefore, treatment of adenomyosis requires not only a focus on symptom improvement but also the protection of vital structures, consideration of fertility needs, and long-term disease management. This review summarizes the characteristics of thermal ablation technologies, clinical decision-making, symptom control, fertility preservation, combination therapies, and safety, aiming to provide a reference for clinical practice in the thermal ablation treatment of adenomyosis. |
| Key words: adenomyosis thermal ablation high-intensity focused ultrasound(HIFU) radiofrequency ablation(RFA) microwave ablation(MWA) |
