Mao Alexandra J, Anastasi Joyce K
Columbia University School of Nursing, New York, New York 10032, USA.
J Am Acad Nurse Pract. 2010 Feb;22(2):109-16. doi: 10.1111/j.1745-7599.2009.00475.x.
To discuss the etiology, clinical presentation, diagnosis, and management of endometriosis for the advanced practice nurse (APN) in primary care.
Selected research, clinical studies, clinical practice guidelines, and review articles.
Commonly encountered by the APN in primary care, endometriosis is a chronic, progressive inflammatory disease characterized by endometrial lesions, cysts, fibrosis, or adhesions in the pelvic cavity, causing chronic pelvic pain and infertility in women of reproductive age. Because of its frequently normal physical examination findings, variable clinical presentations, and nonspecific, overlapping symptoms with other conditions, endometriosis can be difficult to diagnose. As there currently are no accurate noninvasive diagnostic tests specific for endometriosis, it is imperative for the APN to become knowledgeable about the etiology, clinical presentation, diagnosis, and current treatment options of this disease.
The APN in primary care plays an essential role in health promotion through disease management and infertility prevention by providing support and much needed information to the patient with endometriosis. APNs can also facilitate quality of care and manage treatments effectively to improve quality of life, reduce pain, and prevent further progression of disease. Practice recommendations include timely diagnosis, pain management, infertility counseling, patient education, and support for quality of life issues.
为初级保健中的高级执业护士（APN）探讨子宫内膜异位症的病因、临床表现、诊断及管理。
选定的研究、临床研究、临床实践指南及综述文章。
子宫内膜异位症在初级保健中常被APN遇到，是一种慢性进行性炎症性疾病，其特征为盆腔内出现子宫内膜病变、囊肿、纤维化或粘连，导致育龄期女性慢性盆腔疼痛和不孕。由于其体格检查结果常正常、临床表现多样，且症状与其他病症非特异性重叠，子宫内膜异位症可能难以诊断。鉴于目前尚无针对子宫内膜异位症的准确无创诊断测试，APN必须熟知该疾病的病因、临床表现、诊断及当前治疗选择。
初级保健中的APN通过疾病管理和预防不孕，为子宫内膜异位症患者提供支持和急需的信息，在健康促进中发挥重要作用。APN还可促进护理质量并有效管理治疗，以改善生活质量、减轻疼痛并防止疾病进一步发展。实践建议包括及时诊断、疼痛管理、不孕咨询、患者教育以及对生活质量问题的支持。
