子宫腺肌病的患者教育及全程管理

doi:10.6040/j.issn.1671-7554.0.2022.0467

摘要/Abstract

摘要： 子宫腺肌病引起痛经、月经过多及不孕不育,是影响育龄女性身心健康的慢性病之一,其治疗成效离不开良好的患者教育与规范的全程管理。信息社会与数字医疗的进步给患者教育的形式与内容均带来创新与便捷。本文就如何以子宫腺肌病患者为核心,提高患者对疾病的认知以及对治疗的依从性展开讨论;就如何提升患者对于月经量与生育力的自我评估能力提出建议;同时鼓励设计高质量临床研究,激励医务、伴侣、病友及社会等四方协同支持,促进科学且可持续的全程管理。

关键词: 子宫腺肌病, 患者教育, 月经管理, 生育管理, 四方支持

Abstract: Adenomyosis, one of the chronic gynecological diseases manifested by dysmenorrhea, heavy menstrual bleeding or infertility, negatively impacts the health of women of childbearing age. Patient education and proper management are important components of quality patient care. Advancement in digital medicine brings innovation in patient education materials and modalities. This review aims to strengthen ‘patient-centered’ value and increase patients knowledge on adenomyosis as well as compliance on management. Specific advice is provided to improve patients self-evaluation on the menstrual health and fertility, supplemented by well-designed clinical trials. In addition, the supporting roles of medical practitioners, partners, patients and society need to be pulled together to promote better outcome in long-term management of adenomyosis.

Key words: Adenomyosis, Patient education, Menstrual health management, Fertility preserving management, Four facets of support

中图分类号:

R711.74

易晓芳,黄季华. 子宫腺肌病的患者教育及全程管理[J]. 山东大学学报 (医学版), 2022, 60(7): 32-35.

YI Xiaofang, HUANG Jihua. Patient education and proper management of adenomyosis[J]. Journal of Shandong University (Health Sciences), 2022, 60(7): 32-35.

参考文献

[1] 冷金花. 子宫腺肌病诊治中国专家共识[J]. 中华妇产科杂志, 2020, 55(6): 376-383.
[2] Yu O, Schulze-Rath R, Grafton J, et al. Adenomyosis incidence, prevalence and treatment: United States population-based study 2006-2015 [J]. Am J Obstet Gynecol, 2020, 223(1): 94.e1-94.e10.
[3] 宁吉喆. 第七次全国人口普查主要数据情况[J]. 中国统计, 2021(5): 4-5.
[4] Okazaki K, Oka F, Ishihara H, et al. Cerebral infarction associated with benign mucin-producing adenomyosis: report of two cases [J]. BMC Neurol, 2018, 18(1): 166.
[5] Bourdon M, Oliveira J, Marcellin L, et al. Adenomyosis of the inner and outer myometrium are associated with different clinical profiles [J]. Hum Reprod, 2021, 36(2): 349-357.
[6] Yajima R, Kido A, Kurata Y, et al. Diffusion-weighted imaging of uterine adenomyosis: correlation with clinical backgrounds and comparison with malignant uterine tumors [J]. J Obstet Gynaecol Res, 2021, 47(3): 949-960.
[7] Tellum T, Nygaard S, Skovholt EK, et al. Development of a clinical prediction model for diagnosing adenomyosis [J]. Fertil Steril, 2018, 110(5): 957-964.
[8] Liu X, Ding D, Ren Y, et al. Transvaginal elastosonography as an imaging technique for diagnosing adenomyosis [J]. Reprod Sci, 2018, 25(4): 498-514.
[9] Xie M, Yu H, Zhang X, et al. Elasticity of adenomyosis is increased after GnRHa therapy and is associated with spontaneous pregnancy in infertile patents [J]. J Gynecol Obstet Hum Reprod, 2019, 48(10): 849-853.
[10] 郎景和, 冷金花, 邓姗, 等. 左炔诺孕酮宫内缓释系统临床应用的中国专家共识[J]. 中华妇产科杂志, 2019, 54(12): 815-825.
[11] Takamura M, Koga K, Harada M,et al. A case of hemorrhagic shock occurred during dienogest therapy for uterine adenomyosis [J]. J Obstet Gynaecol Res, 2020, 46(12): 2696-2700.
[12] Huang R, Li X, Jiang H, et al. Barriers to self-management of patients with adenomyosis: a qualitative study [J]. Nurs Open, 2022, 9(2): 1086-1095.
[13] de Bruijn AM, Smink M, Hehenkamp WJK, et al. Uterine artery embolization for symptomatic adenomyosis: 7-year clinical follow-up using UFS-Qol questionnaire [J]. Cardiovasc Intervent Radiol, 2017, 40(9): 1344-1350.
[14] Cheung VY. Current status of high-intensity focused ultrasound for the management of uterine adenomyosis [J]. Ultrasonography, 2017, 36(2): 95-102.
[15] Kobayashi H, Imanaka S. Proposal for developing treatment algorithms of women with symptomatic adenomyosis: a single-center experience [J]. J Obstet Gynaecol Res, 2021, 47(9): 3257-3268.
[16] Alfonsin MM, Chapon R, de Souza CAB, et al. Correlations among algometry, the visual analogue scale, and the numeric rating scale to assess chronic pelvic pain in women [J]. Eur J Obstet Gynecol Reprod Biol X, 2019, 3: 100037. doi: 10.1016/j.eurox.2019.100037.
[17] Spence M, de Repentigny K, Bowman M, et al. Validation of the pictorial blood loss assessment chart using modern sanitary products [J]. Haemophilia, 2021, 27(5): e632-e635.
[18] 中国医师协会妇产科医师分会, 中华医学会妇产科学分会子宫内膜异位症协作组. 子宫内膜异位症诊治指南(第三版)[J]. 中华妇产科杂志, 2021, 56(12): 812-824.
[19] Soave I, Wenger JM, Pluchino N, et al. Treatment options and reproductive outcome for adenomyosis-associated infertility [J]. Curr Med Res Opin, 2018, 34(5): 839-849.
[20] Kishi Y, Yabuta M, Taniguchi F. Who will benefit from uterus-sparing surgery in adenomyosis-associated subfertility? [J]. Fertil Steril, 2014, 102(3): 802-807.
[21] Won S, Hwang JY, Lee N, et al. Anti-Müllerian hormone level may predict successful pregnancy after adenomyomectomy in patients with infertility due to adenomyosis [J]. Medicine(Baltimore), 2021, 100(21): e26075. doi: 10.1097/MD.0000000000026075.
[22] Guo SW, Groothuis PG. Is it time for a paradigm shift in drug research and development in endometriosis/adenomyosis? [J]. Hum Reprod Update, 2018, 24(5): 577-598.
[23] de Bruijn AM, Lohle PN, Huirne JA, et al. Uterine artery embolization versus hysterectomy in the treatment of symptomatic adenomyosis: protocol for the randomized QUESTA Trial [J]. JMIR Res Protoc, 2018, 7(3): e47. doi: 10.2196/resprot.8512.
[24] Latif S, Wattar BHA, Balachandren N, et al. Effectiveness of modified downregulation for women with moderate and severe adenomyosis of the uterus prior to frozen thawed embryo transfer(MODA)study protocol: a pragmatic randomised-controlled trial [J]. BMJ Open, 2021, 11(10): e050248. doi: 10.1136/bmjopen-2021-050248.
[25] Nelsen LM, Lenderking WR, Pokrzywinski R, et al. Experience of symptoms and disease impact in patients with adenomyosis [J]. Patient, 2018, 11(3): 319-328.

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