Wood C
Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia.
Hum Reprod Update. 1998 Jul-Aug;4(4):323-36. doi: 10.1093/humupd/4.4.323.
The treatment of adenomyosis has been limited by the difficulty and delay associated with the diagnosis, often not until after hysterectomy. Magnetic resonance imaging, high resolution vaginal ultrasound and uterine biopsy have improved early detection of adenomyosis. Drug therapy may be effective in controlling symptoms but the frequent coexistence of endometriosis and the lack of controlled studies make their efficacy difficult to quantify. Conservative surgery involving endomyometrial ablation, laparoscopic myometrial electrocoagulation or excision has proven to be effective in >50% of patients, although follow-up has been restricted to 3 years. Hysterectomy will still be necessary in severe cases of adenomyosis. Early diagnosis may improve treatment. Investigations are indicated in women with menstrual pain or menorrhagia not responding to drug therapy.
子宫腺肌病的治疗一直受到诊断困难和延迟的限制，通常直到子宫切除术后才得以诊断。磁共振成像、高分辨率阴道超声和子宫活检已改善了子宫腺肌病的早期检测。药物治疗可能对控制症状有效，但子宫内膜异位症的频繁共存以及缺乏对照研究使得其疗效难以量化。涉及子宫内膜肌层消融、腹腔镜子宫肌层电凝或切除的保守手术已被证明在超过50%的患者中有效，尽管随访时间限制在3年。在子宫腺肌病的严重病例中，子宫切除术仍然是必要的。早期诊断可能会改善治疗效果。对于药物治疗无效的痛经或月经过多的女性，建议进行相关检查。
