子宫内膜异位症长期管理策略
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摘要
子宫内膜异位症是一种常见的影响女性生殖健康及家庭幸福的慢性病。应建立以临床问题为导向、年龄为分层、多维度的综合长期管理方案,规范手术的时机和方式,强调药物治疗的主导作用,重视随访和教育,旨在提高患者的生活质量。
Endometriosis is a common chronic disease that affects women's reproductive health and family well-being. A comprehensive long-term management scheme based on clinical symptoms,age stratification and multi-dimensional factors should be established. The timing and mode of surgery ought to be standardized,and the leading role of drug therapy should be emphasized. Due attention should be paid to the follow-up and health education so as to improve patients' quality of life.
Endometriosis is a common chronic disease that affects women's reproductive health and family well-being. A comprehensive long-term management scheme based on clinical symptoms,age stratification and multi-dimensional factors should be established. The timing and mode of surgery ought to be standardized,and the leading role of drug therapy should be emphasized. Due attention should be paid to the follow-up and health education so as to improve patients' quality of life.
引文
[1]冷金花,史精华.子宫内膜异位症复发的高危因素及其防治策略[J].中华妇产科杂志,2018,53(9):640-643.LENG Jinhua,SHI Jinghua.Risk factors and treatments of endometriosis recurrence[J].Chinese Journal of Obstetrics and Gynecology,2018,53(9):640-643.
[2]Menakaya U,Infante F,Condous G.Consensus on current management of endometriosis[J].Human reproduction(Oxford,England),2013,28(11):3162-3163.
[3]中华医学会妇产科学分会子宫内膜异位症协作组.子宫内膜异位症的诊治指南[J].中华妇产科杂志,2015,50(3):161-169.Cooperative Group of Endometriosis,Chinese Society of Obstetrics and Gynecology,Chinese Medical Association.Guideline for the diagnosis and treatment of endometriosis[J].Chinese Journal of Obstetrics and Gynecology,2015,50(3):161-169.
[4]中国医师协会妇产科医师分会子宫内膜异位症专业委员会,中华医学会妇产科学分会子宫内膜异位症协作组.子宫内膜异位症长期管理中国专家共识[J].中华妇产科杂志,2018,53(12):836-841.Endometriosis Committee,Chinese Obstetricians and Gynecologists Association;Cooperative Group of Endometriosis,Chinese Society of Obstetrics and Gynecology,Chinese Medical Association.Chinese consensus on the long term management of endometriosis[J].Chinese Journal of Obstetrics and Gynecology,2018,53(12):836-841.
[5]Bulun SE,Yilmaz BD,Sison C,et al.Endometriosis[J].Endocrine Reviews,2019,17.doi:10.1210/er.2018-00242.
[6]Patel BG,Lenk EE,Lebovic DI,et al.Pathogenesis of endometriosis:Interaction between Endocrine and inflammatory pathways.Best practice&research[J].Clinical Obstetrics&Gynaecology,2018,50:50-60.doi:10.1016/j.bpobgyn.2018.01.006.
[7]Rogers PA,Adamson GD,Al-Jefout M,et al.Research Priorities for Endometriosis:Recommendations From a Global Consortium of Investigators in Endometriosis[J].Reproductive Sciences,2016,24(2):202.
[8]冷金花,戴毅.子宫内膜异位症治疗新观念[J].中华妇产科杂志,2017,52(7):433-435.LENG Jinhua,DAI Yi.Treatment of endometriosis:newideas[J].Chinese Journal of Obstetrics and Gynecology,2017,52(7):433-435.
[9]Roman H,Ballester M,Loriau J,et al.Strategies and surgical management of endometriosis:CNGOF-HAS Endometriosis Guidelines[J].Gynecologie,Obstetrique,Fertilite&Senologie,2018,46(3):326-330.
[10]Broi MGD,Ferriani RA,Navarro PA.Ethiopathogenic mechanisms of endometriosis-related infertility[J].JBRA Assisted Reproduction,2019,15.doi:10.5935/1518-0557.20190029.
[11]Dunselman GAJ,Vermeulen N,Becker C,et al.ESHREguideline:management of women with endometriosis[J].Human Reproduction,2014,29(3):400-412.
[12]Casper RF.Progestin-only pills may be a better first-line treatment for endometriosis than combined estrogen-progestin contraceptive pills[J].Fertility and Sterility,2017,107(3):533-536.
[13]Geoffron S,Cohen J,Sauvan M,et al.Endometriosis medical treatment:hormonal treatment for the management of pain and endometriotic lesions recurrence.CNGOF-HAS Endometriosis Guidelines[J].Gynecologie,Obstetrique,Fertilite&Senologie,2018,46(3):231-247.
[14]Vrettakos C,Bajaj T.Levonorgestrel.StatPearls[M].Treasure Island(FL):StatPearls Publishing LLC,2019.
[15]Zhao RH,Sun WW,Liu Y,et al.Chinese Medicine in Management of Chronic Disease Endometriosis[J].Chinese Journal of Integrative Medicine,2018.doi:10.1007/s11655-018-2937-3.
[16]Sauvan M,Chabbert-Buffet N,Canis M,et al.Medical treatment for the management of painful endometriosis without infertility:CNGOF-HAS Endometriosis Guidelines[J].Gynecologie,Obstetrique,Fertilite&Senologie,2018,46(3):267-272.
[17]Bayoglu Tekin Y,Dilbaz B,Altinbas SK,et al.Postoperative medical treatment of chronic pelvic pain related to severe endometriosis:levonorgestrel-releasing intrauterine system versus gonadotropin-releasing hormone analogue[J].Fertility and Sterility,2011,95(2):492-496.
[18]Rolla E.Endometriosis:advances and controversies in classification,pathogenesis,diagnosis,and treatment[J].F1000 Research,2019,8.doi:10.12688/f1000research.14817.1.e Collection 2019.
[19]Chauffour C,Pouly JL,Gremeau AS.Management by assisted reproductive technology in women with endometriosis:CNGOF-HAS Endometriosis Guidelines[J].Gynecologie,Obstetrique,Fertilite&Senologie,2018,46(3):338-348.
[20]Duffy JMN,Arambage K,Correa FJS,et al.Laparoscopic surgery for endometriosis[J].Cochrane Database of Systematic Reviews,2014,3(4):CD011031.doi:10.1002/14651858.CD011031.pub2.
[21]Hobo R,Nakagawa K,Usui C,et al.The Endometriosis Fertility Index Is Useful for Predicting the Ability to Conceive without Assisted Reproductive Technology Treatment after Laparoscopic Surgery,Regardless of Endometriosis[J].Gynecologic and Obstetric Investigation,2018,83(5):493-498.
[22]Pantou A,Simopoulou M.The Role of Laparoscopic investigation in enabling natural conception and avoiding in vitro fertilization overuse for infertile patients of unidentified aetiology and recurrent implantation failure following in vitro fertilization[J].J Clin Med,2019,8(4):548.
[23]Vercellini P,Vigano P,Buggio L,et al.Perimenopausal management of ovarian endometriosis and associated cancer risk:When is medical or surgical treatment indicated?[J].Best Practice&Research,Clinical Obstetrics&Gynaecology,2018,51:151-168.
[24]Sauvan M,Chabbert-Buffet N,Geoffron S,et al.Management of painful endometriosis in adolescents:CNGOF-HAS Endometriosis Guidelines[J].Gynecologie,Obstetrique,Fertilite&Senologie,2018,46(3):264-266.
[25]Saridogan E.Adolescent endometriosis[J].European Journal of Obstetrics,Gynecology,and Reproductive Biology,2017,209:46-49.
[26]Staal AH,van der Zanden M,Nap AW.Diagnostic Delay of Endometriosis in the Netherlands[J].Gynecologic and obstetric investigation,2016,81(4):321-324.
[27]Darwish B,Roman H.Surgical treatment of deep infiltrating rectal endometriosis:in favor of less aggressive surgery[J].Am J Obstet Gynecol,2016,215(2):195-200.
[28]Hudelist G,Tammaa A,Aas-Eng MK.Outcome of sonography-based minimally invasive surgery for deep infiltrating endometriosis of the ureter and urinary bladder-a retrospective cohort study[J].2018,97(3):277-284.
[29]Iversen ML,Seyer-Hansen M,Forman A.Does surgery for deep infiltrating bowel endometriosis improve fertility?A systematic review[J].Acta Obstetricia et Gynecologica Scandinavica,2017,96(6):688-693.
[30]Marie-Scemama L,Even M,De La Joliniere JB,et al.Endometriosis and the menopause:why the question merits our full attention[J].Hormone Molecular Biology and Clinical Investigation,2019,37(2).doi:10.1515/hmbci-2018-0071.
[31]何政星,王姝,冷金花,等.子宫内膜异位症恶变的临床风险分析[J].中华妇产科杂志,2018,53(4):282-284.
[32]Shi J,Leng J,Cui Q,et al.Follicle loss after laparoscopic treatment of ovarian endometriotic cysts[J].Int JGynaecol Obstet,2011,115(3):277-281.
[33]史精华,冷金花,郎景和,等.腹腔镜双侧卵巢子宫内膜异位囊肿剔除术对卵巢储备功能及生育的影响及其相关因素分析[J].现代妇产科进展,2013,22(1):51-53.
[34]Saridogan E,Becker CM,Feki A,et al.Recommendations for the surgical treatment of endometriosis-part 1:ovarian endometrioma[J].Gynecological Surgery,2017,14(1):27.doi:10.1186/s10397-017-1029-x.
[35]Van Niekerk L,Weaver-Pirie B,Matthewson M.Psychological interventions for endometriosis-related symptoms:a systematic reviewwith narrative data synthesis[J].Archives of Women' s Mental Health,2019.doi:10.1007/s00737-019-00972-6.
[36]Vannuccini S,Lazzeri L,Orlandini C,et al.Mental health,pain symptoms and systemic comorbidities in women with endometriosis:a cross-sectional study[J].JPsychosom Obstet Gynaecol,2018,39(4):315-320.
[2]Menakaya U,Infante F,Condous G.Consensus on current management of endometriosis[J].Human reproduction(Oxford,England),2013,28(11):3162-3163.
[3]中华医学会妇产科学分会子宫内膜异位症协作组.子宫内膜异位症的诊治指南[J].中华妇产科杂志,2015,50(3):161-169.Cooperative Group of Endometriosis,Chinese Society of Obstetrics and Gynecology,Chinese Medical Association.Guideline for the diagnosis and treatment of endometriosis[J].Chinese Journal of Obstetrics and Gynecology,2015,50(3):161-169.
[4]中国医师协会妇产科医师分会子宫内膜异位症专业委员会,中华医学会妇产科学分会子宫内膜异位症协作组.子宫内膜异位症长期管理中国专家共识[J].中华妇产科杂志,2018,53(12):836-841.Endometriosis Committee,Chinese Obstetricians and Gynecologists Association;Cooperative Group of Endometriosis,Chinese Society of Obstetrics and Gynecology,Chinese Medical Association.Chinese consensus on the long term management of endometriosis[J].Chinese Journal of Obstetrics and Gynecology,2018,53(12):836-841.
[5]Bulun SE,Yilmaz BD,Sison C,et al.Endometriosis[J].Endocrine Reviews,2019,17.doi:10.1210/er.2018-00242.
[6]Patel BG,Lenk EE,Lebovic DI,et al.Pathogenesis of endometriosis:Interaction between Endocrine and inflammatory pathways.Best practice&research[J].Clinical Obstetrics&Gynaecology,2018,50:50-60.doi:10.1016/j.bpobgyn.2018.01.006.
[7]Rogers PA,Adamson GD,Al-Jefout M,et al.Research Priorities for Endometriosis:Recommendations From a Global Consortium of Investigators in Endometriosis[J].Reproductive Sciences,2016,24(2):202.
[8]冷金花,戴毅.子宫内膜异位症治疗新观念[J].中华妇产科杂志,2017,52(7):433-435.LENG Jinhua,DAI Yi.Treatment of endometriosis:newideas[J].Chinese Journal of Obstetrics and Gynecology,2017,52(7):433-435.
[9]Roman H,Ballester M,Loriau J,et al.Strategies and surgical management of endometriosis:CNGOF-HAS Endometriosis Guidelines[J].Gynecologie,Obstetrique,Fertilite&Senologie,2018,46(3):326-330.
[10]Broi MGD,Ferriani RA,Navarro PA.Ethiopathogenic mechanisms of endometriosis-related infertility[J].JBRA Assisted Reproduction,2019,15.doi:10.5935/1518-0557.20190029.
[11]Dunselman GAJ,Vermeulen N,Becker C,et al.ESHREguideline:management of women with endometriosis[J].Human Reproduction,2014,29(3):400-412.
[12]Casper RF.Progestin-only pills may be a better first-line treatment for endometriosis than combined estrogen-progestin contraceptive pills[J].Fertility and Sterility,2017,107(3):533-536.
[13]Geoffron S,Cohen J,Sauvan M,et al.Endometriosis medical treatment:hormonal treatment for the management of pain and endometriotic lesions recurrence.CNGOF-HAS Endometriosis Guidelines[J].Gynecologie,Obstetrique,Fertilite&Senologie,2018,46(3):231-247.
[14]Vrettakos C,Bajaj T.Levonorgestrel.StatPearls[M].Treasure Island(FL):StatPearls Publishing LLC,2019.
[15]Zhao RH,Sun WW,Liu Y,et al.Chinese Medicine in Management of Chronic Disease Endometriosis[J].Chinese Journal of Integrative Medicine,2018.doi:10.1007/s11655-018-2937-3.
[16]Sauvan M,Chabbert-Buffet N,Canis M,et al.Medical treatment for the management of painful endometriosis without infertility:CNGOF-HAS Endometriosis Guidelines[J].Gynecologie,Obstetrique,Fertilite&Senologie,2018,46(3):267-272.
[17]Bayoglu Tekin Y,Dilbaz B,Altinbas SK,et al.Postoperative medical treatment of chronic pelvic pain related to severe endometriosis:levonorgestrel-releasing intrauterine system versus gonadotropin-releasing hormone analogue[J].Fertility and Sterility,2011,95(2):492-496.
[18]Rolla E.Endometriosis:advances and controversies in classification,pathogenesis,diagnosis,and treatment[J].F1000 Research,2019,8.doi:10.12688/f1000research.14817.1.e Collection 2019.
[19]Chauffour C,Pouly JL,Gremeau AS.Management by assisted reproductive technology in women with endometriosis:CNGOF-HAS Endometriosis Guidelines[J].Gynecologie,Obstetrique,Fertilite&Senologie,2018,46(3):338-348.
[20]Duffy JMN,Arambage K,Correa FJS,et al.Laparoscopic surgery for endometriosis[J].Cochrane Database of Systematic Reviews,2014,3(4):CD011031.doi:10.1002/14651858.CD011031.pub2.
[21]Hobo R,Nakagawa K,Usui C,et al.The Endometriosis Fertility Index Is Useful for Predicting the Ability to Conceive without Assisted Reproductive Technology Treatment after Laparoscopic Surgery,Regardless of Endometriosis[J].Gynecologic and Obstetric Investigation,2018,83(5):493-498.
[22]Pantou A,Simopoulou M.The Role of Laparoscopic investigation in enabling natural conception and avoiding in vitro fertilization overuse for infertile patients of unidentified aetiology and recurrent implantation failure following in vitro fertilization[J].J Clin Med,2019,8(4):548.
[23]Vercellini P,Vigano P,Buggio L,et al.Perimenopausal management of ovarian endometriosis and associated cancer risk:When is medical or surgical treatment indicated?[J].Best Practice&Research,Clinical Obstetrics&Gynaecology,2018,51:151-168.
[24]Sauvan M,Chabbert-Buffet N,Geoffron S,et al.Management of painful endometriosis in adolescents:CNGOF-HAS Endometriosis Guidelines[J].Gynecologie,Obstetrique,Fertilite&Senologie,2018,46(3):264-266.
[25]Saridogan E.Adolescent endometriosis[J].European Journal of Obstetrics,Gynecology,and Reproductive Biology,2017,209:46-49.
[26]Staal AH,van der Zanden M,Nap AW.Diagnostic Delay of Endometriosis in the Netherlands[J].Gynecologic and obstetric investigation,2016,81(4):321-324.
[27]Darwish B,Roman H.Surgical treatment of deep infiltrating rectal endometriosis:in favor of less aggressive surgery[J].Am J Obstet Gynecol,2016,215(2):195-200.
[28]Hudelist G,Tammaa A,Aas-Eng MK.Outcome of sonography-based minimally invasive surgery for deep infiltrating endometriosis of the ureter and urinary bladder-a retrospective cohort study[J].2018,97(3):277-284.
[29]Iversen ML,Seyer-Hansen M,Forman A.Does surgery for deep infiltrating bowel endometriosis improve fertility?A systematic review[J].Acta Obstetricia et Gynecologica Scandinavica,2017,96(6):688-693.
[30]Marie-Scemama L,Even M,De La Joliniere JB,et al.Endometriosis and the menopause:why the question merits our full attention[J].Hormone Molecular Biology and Clinical Investigation,2019,37(2).doi:10.1515/hmbci-2018-0071.
[31]何政星,王姝,冷金花,等.子宫内膜异位症恶变的临床风险分析[J].中华妇产科杂志,2018,53(4):282-284.
[32]Shi J,Leng J,Cui Q,et al.Follicle loss after laparoscopic treatment of ovarian endometriotic cysts[J].Int JGynaecol Obstet,2011,115(3):277-281.
[33]史精华,冷金花,郎景和,等.腹腔镜双侧卵巢子宫内膜异位囊肿剔除术对卵巢储备功能及生育的影响及其相关因素分析[J].现代妇产科进展,2013,22(1):51-53.
[34]Saridogan E,Becker CM,Feki A,et al.Recommendations for the surgical treatment of endometriosis-part 1:ovarian endometrioma[J].Gynecological Surgery,2017,14(1):27.doi:10.1186/s10397-017-1029-x.
[35]Van Niekerk L,Weaver-Pirie B,Matthewson M.Psychological interventions for endometriosis-related symptoms:a systematic reviewwith narrative data synthesis[J].Archives of Women' s Mental Health,2019.doi:10.1007/s00737-019-00972-6.
[36]Vannuccini S,Lazzeri L,Orlandini C,et al.Mental health,pain symptoms and systemic comorbidities in women with endometriosis:a cross-sectional study[J].JPsychosom Obstet Gynaecol,2018,39(4):315-320.