子宫腺肌症治疗课件.ppt

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1、湖北省妇幼保健院Maternityandchildcarecentersinhubeiprovince王燕WangYanprojectdate20/09/2007高强度聚焦超声治疗子宫腺肌症的临床研究TheClinicalStudyOfUltrasound-guidedHigh-intensityFocusedUltrasoundAblationForAdenomyosis概念onception02子宫腺肌病(adenomyosis,AM)一种常见妇科疾病，多发生在30-50岁经产妇。本病的发病机制尚不清楚Ad

2、enomyosisisacommonGynecologicaldiseasethatusuallyaffectmultiparasof30-to-50year-olds.Thepathogenesisofthisdiseaseisnotclear现状：发病率升高，发病年龄呈下降趋势,对患者生活质量的影响也越来越大Thecurrentsituation:Theincidenceratesrisedwhiletheageofonsetdeclined,theinfluenceonthequalityoflifeof

3、patientsaregettingmoreandmoreserious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Adenomyosismayberelatedtothefactorsofinducedabortion、IUD、tuballigation、curettage、childbirth,etc--whichusuallydamagetheendometri

4、umandshallowmyometrium,causedthebasallayerofendometriuminvadeintomyometrium观察observation手术治疗surgery药物治疗drugs治疗therapy症状Symptoms年龄Age生育要求Desireoffertility,根治性手术Radicalsurgery子宫+双附件切除术Hysterectomyandbilateralsalpingo-oophorectomy(BSO)手术治疗surgicaltreatment保

5、守性手术：Conservativeoperation子宫内膜去除术（Transcervicalesectionofendometrium,TCRE）介入（UterineArterialEmbolization,UAE）腹腔镜子宫动脉结扎术（LaparoscopicUterineArteryLigation,LBUAB）超声聚焦治疗（HighIntensityFocusedUltrasound,HIFU）电消融治疗electricalablation子宫腺肌瘤挖除术myomectomyforuteri

6、nemyoma+腹腔镜子宫动脉阻断术（Laparoscopicuterinearteryblockage,LBUAB）+腹腔镜子宫神经去除术（Laparoscopyuterinenerveablation,LUNA）根治性手术：1%Radicalsurgery保守性手术：80-95%Conservativeoperation治疗方式的选择Thechoiceoftreatments手术治疗的不足之处thedefectsofsurgicaltreatment不能处理微小病灶——复发Can'tdealwiththe

7、smalllesions-Relapse不能去除病因——复发Havebeenunabletoremovethecauses-Relapse增加患者的压力和负担Increasingthepressureandburdenofpatients保留子宫Preservationoftheuterus非侵入性Non-invasive不需麻醉Noanesthesia并发症、副作用少Therewerefewsideeffectsandcomplications保留生育功能Conservefertility可重复性好Well

8、repeatability理想治疗方式Theidealtreatmants研究方法ResearchmethodsHighIntensityFocusedUltrasoundAblationbyHaifu'sModelJC200skin非月经期、非妊娠期、非哺乳期Non-menstrual，un-pregnant，nonpuerperalwomen.经妇检和B超确定为子宫腺肌病患者Gyn