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通过生育保育剂保护子宫功能结构的结果在扩散性腺菌症中进行PUSH手术

Ruifang Wu^1,2,3, Liping Zeng^1,2,3, Qicai Hu^1,2,3

¹Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, P. R. China.

Human fertility (Cambridge, England)

|November 1, 2023

概括

这项研究介绍了PUSH手术,这是一种用于扩散性腺菌症的生育保护手术. 它有效地去除病变,保留子宫结构,并显著改善疼痛和月经出血,孕期的结果良好.

科学领域:

妇科妇科医生妇科
最少侵入性的手术
生殖医学生殖医学

背景情况:

扩散性腺核病在妇科实践中是一个重大挑战,经常需要切除子宫并影响生育能力.
目前扩散性腺菌症的治疗选择可能包括激素疗法或子宫切除术,仅限于保留生育能力的手术解决方案.
在怀孕期间,由于腺菌症的子宫节约手术后,子宫痕破裂的风险仍然令人担忧.

研究的目的:

评估一种新型生育保护手术技术的疗效和安全性,即PUSH (保护子宫结构以治愈) 手术,用于治疗扩散性腺菌症.
评估PUSH手术对减轻疼痛,减小流血以及随后的生育和怀孕结果的影响.
确定PUSH手术的长期复发率和并发症概况.

主要方法:

PUSH手术,涉及 adenomyotic 病变的彻底切除和子宫的重建与重叠的肌肉,在146名患有扩散性腺菌症的患者进行.
患者的子宫在妊娠8至16周之间测量,平均体积为230±150厘米3.
随访延长至156个月,监测疼痛评分 (VAS),月经出血,生育能力,怀孕结果和并发症.

主要成果:

平均VAS疼痛得分显著减少,从手术前的9.4±1.2降至1年后的0.3±0.8和手术后的2年后的0.6±1.0,持续缓解率为96.4%.
100%的患有严重月经潮的患者在2年内达到正常的月经量.
在31名试图怀孕的患者中,术后怀孕率为58%,子宫内活胚胎率为60.0%,怀孕患者没有子宫破裂.

结论:

PUSH手术是一种有希望的扩散性腺核瘤的生育保护方法,可使激进的损伤切除和有效的子宫重建.
该程序显示了疼痛和阴道痛的显著改善,以及有利的怀孕和活产率.
PUSH手术为患有扩散性腺髓炎的妇女提供了切除子宫的安全和有效替代方案,希望在未来获得生育能力.

关键词:

腺核化症是指腺核化症.在PUSH程序中,使用PUSH程序.腺瘤学腺瘤学生育保护性手术 (FPS) 是一种手术.

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