警惕女人患上“良性癌”

(澳門日報) 2018年01月13日 03:37
警惕女人患上“良性癌”
建議以日記記錄症狀,給醫生作正確判斷。
警惕女人患上“良性癌”
未婚者可作腹部盆腔超聲或直腸超聲檢查
警惕女人患上“良性癌”
適齡生育、母乳餵養及經期避免劇烈運動,都是預防子宮內膜異位症的基本要素。

    警惕女人患上“良性癌” 

    子宮內膜異位症(Endometriosis,EM)是指子宮內膜組織(腺體和間質)在子宮腔被覆內膜及子宮以外的部位出現生長、浸潤、反覆出血,繼而引發疼痛、不孕及結節或包塊等。由於子宮內膜異位症病變廣泛、形態多樣、極具侵襲性和復發性,婦科醫生也把子宮內膜異位症叫做“良性癌”。

    據統計,目前全球有超過10%的育齡女性患上子宮內膜異位症。到目前為止子宮內膜異位症還是一個病因機制不明、發病率高、易復發難治癒的疑難疾病,嚴重影響廣大生育年齡婦女生活品質和家庭幸福。

    病症症狀

    子宮內膜異位症是雌激素依賴性疾病,引起的痛經、不孕以及盆腔包塊是生育年齡婦女主要的臨床表現。隨着女性月經周期的改變,月經期子宮腔的內膜脫落出血,同時在子宮腔以外生長的子宮內膜也有同樣的改變,這種改變導致了局部組織出血、炎性反應,引致疼痛的發生和女性生殖系統解剖結構變形、輸卵管梗阻、卵巢功能的改變,因而導致女性不孕不育。子宮內膜異位症廣泛的病灶造成盆腔內環境的改變、子宮腔內環境的改變、輸卵管功能的改變、卵巢功能的影響、往往還伴隨着子宮內膜息肉發生率的增高,月經不規律,陰道不規則出血,不良妊娠結局隨之發生。

    有月經來潮的女性(包括十七歲以下的)如有以下任何情況之一就可能患了子宮內膜異位症,建議她們用日記記錄疼痛和症狀,以便提供給醫生作出正確判斷。

    • 慢性盆腔痛

    • 周期性疼痛(痛經)影響日常活動和生活品質

    • 性交過程中或之後的深部疼痛

    • 月經周期相關的或周期性的胃腸道症狀,尤其是排便疼痛。

    • 月經周期相關的或周期性的泌尿系統症狀,尤其是血尿或排尿疼痛

    • 與以上一種或多種情況相關的不孕症

    診斷方法

    婦科檢查、超聲檢查、盆腔CT或MRI、血清CA125及腹腔鏡檢查等都是診斷子宮內膜異位症的檢查方法。若腹部或盆腔檢查、超聲或核磁結果正常,也不能排除子宮內膜異位症的可能性,臨床懷疑仍然存在或症狀持續,請考慮行腹腔鏡檢查來確診。對已婚的女性而言,經陰道超聲檢查是很好的初檢項目,未婚者可以作腹部盆腔超聲或直腸超聲檢查。

    治療方法

    子宮內膜異位症治療非常複雜,有藥物保守治療、手術去除病灶、助孕生育等,要根據每個人的不同情況制定合適方案。有生育要求的,考慮生育優先。解決症狀的止痛為主,保護卵巢功能者慎重選擇手術。在治療和觀察過程中告訴患者,一定不忘定期複查,防止病灶惡變的可能。

    預防方法

    妊娠和哺乳是對該病最好的治療,也起到了預防作用。子宮內膜異位症的治療措施中有一個假孕療法就是利用了女性在妊娠和哺乳期不排卵無月經的生理機制達到治療目的。所以,適齡生育、母乳餵養、經期避免劇烈運動、經期嚴禁性生活與先天疾病早治療是預防子宮內膜異位症的基本要素。

    總括而言,如何緩解子宮內膜異位症患者疼痛,提高她們的妊娠生育率,重建子宮內膜異位症患者的完美人生,一直以來都是婦科醫生在臨床上永恆的追求。然而,對每一個可疑和確診的患者而言,子宮內膜異位症是一個長期的狀態,可能會產生生理、性、心理及社會方面的影響。所以呼籲全社會加以關注,建立當地的支持團體、網上論壇和慈善團體予以支持和幫助,及時採取措施以促進子宮內膜異位症的診斷和治療,因為拖延會影響她們的生活品質和疾病進展的結果。

    科大醫院婦產科顧問     李先鋒

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Error: Got a packet bigger than 'max_allowed_packet' bytes
Errno.: 1153