小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 无症状
- 月经量过多
- 不规则的坚硬的中央骨盆腔肿瘤
其他诊断因素
- 盆腔疼痛
- 盆腔压迫
- 痛经
- 腹胀
- 乏力和工作效率低下
- 不育症
- 泌尿系统症状
- 便秘
- 增大的子宫（边界清）
- 性交疼痛
危险因素
- 患者体重增加
- 年龄 40-50 岁
- 黑人
- 维生素 D 缺乏
- 高血压
- 月经初潮过早（10 岁以下）
- 使用口服避孕药（在 16 岁前开始服用）
- 未育
- 首次生育时年龄过轻
- 维生素 A 摄入不足
- 牛肉和其他红色肉类摄入高
- 性激素暴露
- 月经史
- 吸烟
- 饮酒
诊断性检查
首要检查
- 超声
- 子宫内膜活检
需考虑的检查
- 子宫腔声学造影
- 宫腔镜检查
- 核磁共振成像 (MRI)
- 腹腔镜
新兴检查
- 超声弹性成像
- MR 弹性成像
治疗流程
有生育要求
无生育要求
撰稿人
作者
Ayman Al-Hendy, MD PhD FRCSC FACOG CCRP
Professor (visiting) and Director
Translational Research
Department of Obstetrics and Gynecology
University of Illinois
Chicago
IL
利益声明
AAH serves on the external advisory board of Bayer, AbbVie, Myovant, and Allergan, and has received research funding from the National Institutes of Health. AAH is an author of references cited in this topic.
Obianuju Sandra Madueke-Laveaux, MD MPH
Assistant Professor of Obstetrics and Gynecology
Department of Obstetrics and Gynecology
University of Illinois
Chicago
IL
利益声明
OSML declares that she has no competing interests. OSML is an author of references cited in this topic.
Vuslat Lale Bakir, MD
Assistant Professor of Obstetrics and Gynecology
Department of Obstetrics and Gynecology
Haseki Training and Research Hospital
Health Sciences University
Istanbul
Turkey
利益声明
VLB declares that she has no competing interests.
鸣谢
Dr Al-Hendy, Dr Madueke-Laveaux, and Dr Bakir would like to gratefully acknowledge Dr Mohamed Mitwally, Dr Intisar Elnahhas, and Dr Robert J. Fischer, the previous contributors to this topic.
利益声明
MM, IE, and RJF declare that they have no competing interests.
同行评议者
Everett Magann, MD
Chairman
Department of Obstetrics and Gynecology
Naval Medical Center
Portsmouth
VA
利益声明
EM declares that he has no competing interests.
Amy Niederhauser, MD
Doctor
Department of Obstetrics and Gynecology
Naval Medical Center
Portsmouth
VA
利益声明
AN declares that she has no competing interests.
Adam Magos, BSc, MB, BS, MD, FRCOG
Consultant Gynaecologist
University Department of Obstetrics and Gynaecology
Royal Free Hospital
London
UK
利益声明
AM declares that he has no competing interests.
鉴别诊断
- 子宫腺肌病
- 子宫内膜息肉
- 子宫内膜增生
更多 鉴别诊断指南
- 严重月经出血：评估与管理
- 美国放射学学会标准：临床可疑的附件区包块
更多 指南患者教育信息
纤维瘤
子宫肌瘤：要询问医生的问题
更多 患者教育信息
Log in or subscribe to access all of BMJ Best Practice
内容使用需遵循免责声明