国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2016, Vol. 35 ›› Issue (3): 233-236.

• 综述 • 上一篇    下一篇

合并子宫肌瘤的不孕症之手术策略

赵桂君，陈蓉   

  1. 100022 北京市垂杨柳医院妇产科（赵桂君）；中国医学科学院 北京协和医学院 北京协和医院妇产科（陈蓉）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2016-05-15 发布日期:2016-05-15
  • 通讯作者: 陈蓉

Operational Strategies of Infertility Complicated with Uterine Myomas

ZHAO Gui-jun, CHEN Rong   

  1. Department of Obstetrics and Gynecology, Peking Chui Yang Liu Hospital, Beijing 100022, China (ZHAO Gui-jun); Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China (CHEN Rong)
  • Received:1900-01-01 Revised:1900-01-01 Published:2016-05-15 Online:2016-05-15
  • Contact: CHEN Rong

PDF (PC)

7943

摘要： 探讨不同部位、大小及数目的子宫肌瘤对妊娠的不同影响，分析合并子宫肌瘤的不孕症患者手术指征的选择，临床上不同手术方式对妊娠结局的影响及术后妊娠时机的选择。黏膜下、肌壁间和浆膜下子宫肌瘤对生育率的影响呈递减次序。黏膜下肌瘤对生育影响最大，有症状的黏膜下肌瘤应予切除，不推荐切除浆膜下肌瘤。对不明原因不孕合并肌壁间肌瘤的女性手术治疗需综合多因素，全面评估，进行个体化治疗。新兴的子宫肌瘤治疗方法如高强度聚焦超声和子宫动脉栓塞术不适用于有妊娠意愿的妇女。肌瘤剔除术后应个体化选择避孕时间，对术后肌瘤复发和妊娠后子宫破裂需要重视。

关键词: 子宫肿瘤, 肌瘤, 不育, 女（雌）性, 妇科外科手术, 妊娠

Abstract: The effects of myomas position, size and number on pregnancy, the operational indications of infertility complicated with uterine myomas, the effects of different operation ways on the pregnancy outcomes, and the optimal time of conceive after myomectomy were reviewed in this paper. The influence on fertility is in a decreasing order among submucosal, intramural and subserosal myomas, which means that the influence of submucosal myomas on fertility is greatest, and that the submucosal myomas with clinical symptoms should be removed while the subserosal myomas should not be recommended for operation. Operation treatment for the unexplained infertility should be based on the comprehensive evaluation on multiple factors and the strategy of individual-based treatment. Some new methods, such as the high-intensity focused ultrasound and the uterine-artery embolization, don′t fit for those women with pregnancy planning. Contraceptive time after operation should be adopted accordingly. It should be paid attention to the recurrence of myomas and the uterine rupture during pregnancy or labor after myomectomy.

Key words: Uterine neoplasms, Myoma, Infertility, female, Gynecologic surgical procedures, Pregnancy