Winkel Craig A
Department of Obstetrics and Gynecology, Georgetown University, Washington, DC 20007, USA.
Obstet Gynecol. 2003 Aug;102(2):397-408. doi: 10.1016/s0029-7844(03)00474-5.
Endometriosis is a condition that often leads to a variety of symptoms that range from pain complaints to infertility. Endometriosis is also found in women who are asymptomatic. The diagnosis of endometriosis can be made clinically with reliability similar to that of one made surgically. Medical treatment options are effective, as are surgical treatment options. Complications associated with surgery, however, push the balance in favor of medical therapy whenever possible. Based on the body of evidence available at present, women with endometriosis-related complaints should be treated with a first-line medical therapy. If that fails, a second-line medical therapy is warranted under most conditions. Laparoscopic surgery should be reserved for patients in whom second-line medical therapy has failed or is contraindicated by desire to conceive immediately or as soon as possible.
子宫内膜异位症是一种常引发多种症状的病症，症状范围从疼痛主诉到不孕不等。无症状女性中也可发现子宫内膜异位症。子宫内膜异位症的诊断可通过临床手段做出，其可靠性与手术诊断相似。药物治疗方案有效，手术治疗方案同样如此。然而，与手术相关的并发症使得在任何可能的情况下都倾向于选择药物治疗。基于目前可得的证据，有子宫内膜异位症相关主诉的女性应接受一线药物治疗。如果一线治疗失败，在大多数情况下有必要采用二线药物治疗。腹腔镜手术应保留给二线药物治疗失败或因希望立即或尽快受孕而禁忌二线药物治疗的患者。
