子宫肌瘤的个性化治疗原则.pptVIP

4.3 Vaginal myomectomy（经阴道子宫肌瘤切除术） Treatment Large myomas arising from the uterine body may fill the vagina and result in intermenstrual bleeding, unhealthy discharge, or urinary retention. 来源于宫体的大肌瘤可能填满阴道，导致月经间期出血，不洁分泌物或尿潴留。 Most of these can be enucleated per vaginum and the stalk ligated. 大部分这类肌瘤可经阴道剜出，并将瘤蒂结扎。 Treatment an intraoperative clinical photograph of partial (right-sided) inversion of uterine fundus caused by a large stalked myoma arising from the fundus. 来源于宫底的带蒂大肌瘤导致部分（右侧）子宫底的内翻 Treatment Hysterectomy When childbearing considerations have been fulfilled there is reasonable likelihood of malignancy the most common major gynecological surgical procedure 33.5% are done for myomas 4.4 Hysterectomy（子宫切除） Treatment Hysterectomy eliminates the need for progestational agents a high degree of patient satisfaction enables the woman to take unopposed estrogen therapy Treatment A clinical photograph of leiomyosarcoma arising in a leiomyomatous uterus as seen at hysterectomy. 子宫切除术中所见子宫平滑肌肉瘤 Treatment a nondescent vaginal hysterectomy of a myomatous uterus in progress. 正在进行的阴式子宫切除术 Treatment An intraoperative photograph of a false broad ligament myoma taken at hysterectomy. 子宫切除术时见一假性阔韧带肌瘤 Treatment An intraoperative clinical photograph of enucleation of a true broad ligament myoma. 子宫切除术中见一真性阔韧带肌瘤 Treatment A normal sized uterine body sitting atop a large posterior cervical myoma after hysterectomy. 一正常大小子宫位于一个大的宫颈后肌瘤的上方 Treatment 5. High Intensity Focused Ultrasound(HIFU) High Intensity Focused Ultrasound (HIFU) is a highly precise medical procedure that applies high-intensity focused sonic energy to locally heat and destroy diseased or damaged tissue through ablation. Treatment the basis of this treatment modality The rise in temperature of the tissue the resultant protein denaturation irreversible cell damage Treatment The method uses multiple exposures of high intensity focused ultrasound energy on th