子宫腺肌症治疗.ppt

文献资料： literature information : 可能与人工流产、宫内放置节育器、输卵管结扎、诊断性刮宫、分娩等因素相关——常损伤子宫内膜及浅肌层，导致基底层子宫内膜侵入子宫肌层内生长 Adenomyosis may be related to the factors of induced abortion 、IUD、tubal ligation 、curettage、childbirth,etc--which usually damage the endometrium and shallow myometrium,caused the basal layer of endometrium invade into myometrium 观察 observation 手术治疗 surgery 药物治疗 drugs 根治性手术 Radical surgery ?子宫+双附件切除术 Hysterectomy and bilateral salpingo-oophorectomy (BSO) 根治性手术：1% Radical surgery 保守性手术：80-95% Conservative operation 保留子宫Preservation of the uterus 非侵入性 Non-invasive 不需麻醉No anesthesia 并发症、副作用少There were few side effects and complications 保留生育功能Conserve fertility 可重复性好Well repeatability High Intensity Focused Ultrasound Ablation by Haifus Model JC200 非月经期、非妊娠期、非哺乳期 Non-menstrual ，un-pregnant， nonpuerperal women. 经妇检和B超确定为子宫腺肌病患者 Gynecological examination and Type-B ultrasonic scan evidence of typical features of adenomyosis. 所有病例均有渐进性痛经、经量增多、经期延长以及下腹部坠胀、腰酸、腹痛等症状 All the cases with the clinical symptoms of progressive dysmenorrhea,menorrhagia,menostaxis,next abdominal pain and swelling, lumbar acid,abdominal pain. 无实施镇静镇痛的禁忌证，治疗前均签署知情同意书同意超声消融治疗 Without the contraindications to sedative and analgesic,sign a consent form before treatment. 下腹部瘢痕致明显声衰减或有放射治疗病史 The abdomen scar led to obvious acoustic attenuation or received radiation treatment. 急性感染性疾病未控制、慢性盆腔感染至盆腔器官 Uncontrolled acute infective disease ,the chronic pelvic infection to pelvic organs. 下腹部多次大手术、严重粘连者 Reccived repeatedly abdomina major surgery with seriously adhesions. 盆腔内有金属植入物 There are metal implants in pelvic. 严重心肺疾病史及患者不能俯卧2h者 With history of seriously prior heart and lung disease,inability to lie in a prone position for 2 hours. 合并子宫外脏器内膜异位者未纳入本研究 With the internal organs of the uterus endometriosis. Patient data：Characteristics病例基本资料 Patient data：accompanying symptoms患者资料：伴随症状 预处理：皮肤脱脂、脱气，膀胱及肠道准备 pretreatment： degreasing，degassin