Salazar Christina A, Isaacson Keith, Morris Stephanie
Newton Wellesley Hospital, Harvard Medical School, Newton Wellesley Hospital, Newton, Massachusetts, USA.
Curr Opin Obstet Gynecol. 2017 Aug;29(4):249-256. doi: 10.1097/GCO.0000000000000378.
Intrauterine adhesions, also known as Asherman's syndrome, can have an impact on both reproductive outcomes and gynaecologic symptoms. Understanding the cause of intrauterine adhesions and the common clinical presentation will increase awareness of the condition and guide the patient to appropriate therapy. Surgical management offers favourable fertility outcomes and is often successful in restoring menstruation.
Surgical management with hysteroscopic lysis of adhesions is the gold standard for treatment and adopting an office-based approach offers several advantages. Prevention of reformation of adhesions remains challenging and no single method for preventing recurrence has shown superiority. Cell-based therapies using endometrial stem/progenitor cells hold promise for future use in regenerating inadequate endometrium.
Increased awareness of the symptoms suggestive of intrauterine adhesive disease, as well as recognition of common causes and preceding events, is crucial for early diagnosis, patient counselling and treatment. VIDEO ABSTRACT: http://links.lww.com/COOG/A36.
宫腔粘连,又称阿谢曼综合征,可对生殖结局和妇科症状产生影响。了解宫腔粘连的病因和常见临床表现将提高对该疾病的认识,并指导患者接受适当治疗。手术治疗可带来良好的生育结局,且通常能成功恢复月经。
宫腔镜粘连松解术的手术治疗是金标准,采用门诊治疗方法有诸多优势。预防粘连复发仍具有挑战性,尚无单一预防复发的方法显示出优越性。使用子宫内膜干/祖细胞的细胞疗法有望在未来用于再生不足的子宫内膜。
提高对提示宫腔粘连疾病症状的认识,以及识别常见病因和先前事件,对于早期诊断、患者咨询和治疗至关重要。视频摘要:http://links.lww.com/COOG/A36 。