醫+Check經痛子宮內膜異位檢查計劃

不論年輕與否、曾生育與否,凡有月經的女性
都有機會患上子宮內膜異位/朱古力瘤3,7


每10名處於生育期的女性就有一位患上8
當中,每10個患者高達4個會因此成為不育9
常經痛、經期不規律或經血過多的女性都屬高危,應盡快進行婦科檢查。一個簡單安全、無痛的盆腔超聲波檢查,便可幫助初步診斷出明顯的異位組織8
若及早發現患病,治療或會更有效避免要做手術或不育的機會,從而10

  • 減輕症狀
    如經痛
  • 防止病情惡化和復發,
    以致需要做手術
  • 提高懷孕的機會
 治療方法3,10

  • 藥物
    例如服用荷爾蒙藥物
    (口服黃體素或避孕藥),
    減輕經痛等病症,並
    有效控制及減低子宮
    內膜組織增生
  • 手術治療
    切除異位組織,嚴重
    者或有可能需切除整個子宮或
    卵巢,防止病情惡化
  • 合併治療:手術+藥物
    手術切除異位組織後
    再用藥物治療,有助
    明顯減低復發機會
預防子宮內膜異位復發,建議患者持續治療

子宮內膜異位復發率很高,研究顯示,每10個患者中,高於一半患者會因手術後不服藥而於第5年復發11

根據美國生殖醫學會指引,子宮內膜異位被視為長期疾病,建議患者計劃長期治療,減低因復發而重複做手術的機會12

參考資料

  1. ESHRE. Guideline on Endometriosis 2013. Available at https://www.eshre.eu/Guidelines-and-Legal/Guidelines/Endometriosis-guideline.aspx (Assessed on 10th Jan 2018)
  2. Farquhar C. Endometriosis. BMJ. 2007 Feb 3;334(7587);249-53.
  3. PubMed Health. Endometriosis: Overview. Oct 19, 2017. Available at: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072685/ (Assessed on 2nd Feb 2018)
  4. U.S. Department of Health and Human Services. Endometriosis. Available at: https://www1.nichd.nih.gov/publications/pubs/Documents/endometriosis-2002.pdf (Assesses on 2nd Feb 2018)
  5. ASRM. Endometriosis. A guide for patient revised for 2012.
  6. NHS. Ovarian cyst. http://nhs.uk/conditions/ovarian-cyst/Pages/Introduction.aspx (Accessed on 19th Jan 2017)
  7. The Hospital Authority.子宮內膜異位. Available at: http://www.ha.org.hk/haho/ho/hesd/101575c.htm (Assessed on 6th Feb 2018)
  8. Eskenazi B and Warner ML. Epidemiology of endometriosis. Obstet Gynecol Clin NorthAm. 1997; 24: 235-258.
  9. Ozkan S, Murk W, Arici A. Ann N Y Acad Sci. Endometriosis and infertility: epidemiology and evidence-based treatments. 2008: 1127: 92
  10. Hong Kong Hospital Authority Booklet on “子宮內膜異位”. Available at: http://www.ha.org.hk/haho/ho/hesd/101575c.htm (Assessed on 28th Dec 2016)
  11. Schindler AE. Dienogest in long-term treatment of endometriosis. International Journal of Women’s Health 2011:3 175–184
  12. Practice Committee of the American Society for Reproductive Medicine, Treatment of pelvic pain associated with endometriosis: a committee opinion. Fertil Steril. 2014 Apr; 101(4): 927-35.
  13. Endometriosis Research Center & Women’s Hospital, Inc. Endometriosis Screening & Education Kit Empowering Materials for Understanding and Living Well in Spite of Endometriosis (Developed in Collaboration With The United States Department of Health & Human Services Office on Women’s Health). Updated Edition 2012(Copyright Endometriosis Research Center & Women’s Hospital, Inc. 1997-2012. All Rights Reserved. Version Spring 2012)
  14. Ultrasound scan. Available at: https://www.nhs.uk/conditions/ultrasound-scan/ (Assessed on 10th Jan 2018)
  15. Healthline. What Is a Transvaginal Ultrasound? Available at: https://www.healthline.com/health/transvaginal-ultrasound (Assessed on 10th Jan 2018)

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