子宫腺肌症的最新治疗进展

信号相似

的卵圆形或类圆形的低信号结节或肿块，

致局部子宫壁增厚，

病灶边界模糊，

与周围肌层分

M RI< /p>

技术的发展，高信号灶的发现率随之增高，有报

道弥漫型的发现率 约

40%

，局限型的可达

100%

4

］

。但由于

MRI

价格昂贵

,

不宜 作为首

选。

1.4

超声检查

1.4.1

经腹部超声检查

（Ｔｒａｎｓａｂｄｏｍｉｎａｌ

ｕｌｔｒａ ｓｏｎｏｇｒａｐｈ

ｙ，

ＴＡＵ）

或阴 道超声检查

（Ｔｒａｎｓｖａｇｉｎａ

ｕｌｔｒａｓｏｎｏｇｒａｐｈ

ｙ，ＴＶＵ）

典型声像图表现为

[5]:(1)

子宫均匀增大成球 型

;(2)

宫内回声强弱不均

,

肌层有

多发散在的小囊样低回声反射

;(3)

局限性子宫腺肌症或子宫腺肌瘤表现为子宫壁包块与正常

肌层界 限不清。白爱芳等

[6]

对１６８例子宫腺肌病患者采用经阴道 超声检查与经腹超声检

查，

比较两组患者的诊断准确度。

结果：

ＴＶＵ

检出 ８２例，

漏诊２例，

检出率为９７．

６

rass-r

oots gov

erna

nce a

ccording t

o law is a

n important foundation for promoti

ng the constructi

on

of rule of law, but al

so the most ba

sic development envir

onment. Despite my good

social order in Ge

neral, but there are law

-a

bidi

ng consciousness,

social order is not standard, regar

dless

of faith, Twining visit visit a

nd

other outstanding

problems. We w

ant to active

ly promote t

he field of multi

-level gover

nance accor

ding to la

w

, pr

omote the

continuous improveme

nt of the social e

nvironment. To pr

omote universal complia

nce. Actively foster the r

ule of law

culture

, carry out law publi

city a

nd educati

on

on hone

sty and tr

ustwort

hine

ss, guide the masses a

nd

consci

ously abi

de by the law

, faili

ng to find method, problem-solvi

ng method, method of gradually changi

ng the worl

d, he is not looki

ng for but some

one

ules

w law

, a

bide

by the good atmosphere.

o strengthen t

he comprehensive ma

nagement of publ

ic se

cur

y. Dee

pe

ning peace xi

ngan constr

ucti

on, str

ongly

against viole

nce

crime, mafia and

serious crimi

nal offences, to

protect t

he legitimate rights and interest

s of citize

ns, legal

persons,

carry out criminal

poli

cy of temper justice wit

h mercy, the maximum stimulating

social vitality, a

nd ear

nestly safeguar

d social harm

ony and stability.

To resolve social

confli

cts by law. To furt

her sm

ooth

cha

nnels of reporting social

conditi

ons a

nd

public

opi

nion, improvi

ng regulati

on, ar

bitration, a

s well as

dispute resoluti

on mechani

sms, impleme

nt fully the

petitioners ' cases

-party

ngs and supervi

sing system of letters a

nd cal

ls, and to resolve the i

nvolved law lawsuit into t

he or

bit of rule of la

w

, vexatious, Twini

ng visit visit, distur

bing social

order a

nd

other malici

ous extortion, resol

utely cra

ck down. F

ive, improvi

ng cadre

s V

itale, provi

de strong prote

ction for forest developm

ent

XI Ge

neral Secretary stre

ssed t

hat the compre

hensive revitaliza

tion in

Northeast China,

needs a hig

h quality, solid styl

e, ca

dres of the

dare to pla

y. Ca

dre ca

dres is a pledge,

should

want to do work and abl

e to do good, ent

husiasm is param

ount. Treat party cadres, it is ne

cessary to Strict manageme

nt, and warm care, e

nable t

he br

oad masses of ca

dres work

hard w

ork, this i

s two parall

el principles. In strict a

ccordance wit

h the sta

ndar

ds of good ca

dres se

lecti

on a

nd a

ppoint

ment, the real officers, dare

officer

s, those w

ho wa

nt to play, good as excell

ent ca

dres at all levels

of leadership i

n the pa

st. At prese

nt, some lea

ding

cadres w

ork initiative i

s not

high,

beyond political

, idle

, lazy governance governa

nce, not as, sl

ow

, messy and a phenome

non still exist to varyi

ng de

grees, affected and restricted

economi

c and social development. We m

ust mobilize the e

nthusiasm

of cadres a

s an urge

nt task, adhere to

combi

nation of incentives a

nd

constraints, a

nd a

dhere to the stri

ct management a

nd warm care, pra

ctical soluti

on

s not to

oblem, motivate

cadres and better lea

d the masse

s to an

undertaking

, the ca

dres a

nd create

he ne

w achievement in a

dare to play,

good at show

s as new. To i

dentify the

probl

em, accurate pulse

of law to visit and contribute to make visits to t

he vexatious visits arroga

nce. On t

hese i

ssue

s, we

need to

have a pr

oper

understanding,

shoul

d take the lead to e

stablish a se

nse

of fear of the law, stre

ngthen t

he applicati

on

of the rule

of law and the r

ule of law work

of thinki

ng and take

up responsi

bility for the constructi

on

of the rule

of law. Put learning first. Premise i

s ignorant of the la

w, abi

de by t

he law. Lea

ding ca

dres at all level

s shoul

d take the lea

d in studying t

he Constit

ution a

nd la

ws and regulati

ons

closely related to w

or

k assumed

by, a

n accurate grasp of the ba

sic

positi

on

of our party to a

ddre

ss the i

ssue of the rule

of law

, know

n for the scale to do thi

ngs, figure

out how to use it right, w

hat thing

s do,

what not to do, it can

never

areness of the r

ule of law. Firmly establish the

supremacy of constit

utional law

, l

egal equality before the, right by the law makes the right to

statutory, as well as t

he

rule of law,

develop ha

bits of rul

e of law

, to

discard the r

ule and ca

nnot, must not get overridden

by aut

hority, at the right pre

ssure. Should take the lead to a

bide by. Fulfil its mandate i

n strict a

ccorda

nce wit

h statutory a

uthority and

procedures, no matter what you want to a

dhere t

o the la

w, thought of rule

by law and the rul

e of law to tackle

hot issue

s, effective statutory duty must be, without a

uthori

zation, is not availabl

e. Such as

construction are

as, some cadre

s are be

cause there i

s no procedure is followed

by the rule

s, pai

d a heavy

price, w

e shoul

d learn from them, i

n strict a

ccordance with the law on bi

ddi

ng and im

plementation ... Promise

d to give preferenti

al pol

icies for e

nterpri

ses, hesitant to

cash

or ca

sh not at all. Masses feel strongly about the

se issues, it i

s ne

cessary t

o be solved.

o a

ccel

erate decentralizati

on. S

pecificati

on li

st list list of powers, responsi

bilities a

nd

neg

ative, clearance, revocation does not ada

pt to the current sit

uation of the development of policy

document

s,

espe

cially the rig

ht to admini

strative examination a

nd a

pproval

, the ca

ncellation must be

cancele

d, the

delegation must be de

centralize

d to achieve zer

o-w

ait, one- st

op,

seamless, im

prove admi

nistrative efficiency and servi

ce levels.

In parti

cula

r, the

delegation of powers must be ca

ught

properly,

never able t

o loft is no answ

er, no one care

s, ca

use

backfire, people work

harde

r. To carry out the campaign.

Crack

dow

n on law enfor

cement regulati

ons, uncivil a

nd

not as, a

s undermini

ng economic

development, such as envir

onme

ntal problems,

pay close attention to the grass-r

oots level w

eaknesses, stri

ctly investigate and dea

l with the grass-r

oots level

corr

upti

on and de

nial of Justi

ce agai

nst the intere

sts of the masses, such as corruption a

nd

corr

uption, rut

hless pe

ople ar

ound

onme

nt. In

particular, stre

ngthe

ning the construction of

Governme

nt credit, a

nd trustworthy

practice for companie

s and i

nvestors, and must not break faith with t

he

people, pr

omises a

nd the promi

se to the

society.

To buil

d a new

of law to visit and contribute to make visits to t

he vexatious visits arroga

nce. On t

hese i

ssue

s, we

need to

have a pr

oper

understanding,

shoul

d take the lead to e

stablish a se

nse

of fear of the law, stre

ngthen t

he applicati

on

of the rule

of law and the rule of law w

ork of think

ing and take up responsibility for the construction of the rule of law. Put lear

ning first. Pr

emise is ignorant of the law, a

bide

by the law. Leadi

ng cadre

s at all levels should take the l

ead in

studyi

ng the

Constitution and laws a

nd reg

ulations cl

osely relate

d to w

ork ass

umed by, an a

ccurate grasp of the

basi

c position of our

party to address t

he issue of the r

ule of law, known for the

scale t

o do t

hings, figure out

how t

o use it right

, what thi

ngs do, what not to

do, it ca

n never

o e

nha

nce t

he aware

ness

of the rule of law. Firmly establish t

he supremacy

of constituti

onal la

w

, legal e

quality before the, right

by the law makes the right to statut

ory, as w

ell as

the rule of la

w

, devel

op

habits

of rule of la

w, to di

scard t

he rule a

nd

cannot, must not get overri

dde

n by a

uthorit

y, at the right

pressure. Shoul

d take the lea

d to abi

de by. Fulfil its mandate in stri

ct accordance with stat

utory aut

hority and pr

oce

dures, no matter what y

ou want t

o adhere to the la

w,

thoug

ht of rule by law a

nd t

he rule

of law to tack

le

hot issues, effective statutory duty must be

, without aut

horizati

on, is not available. Such as constructi

on area

s, some cadre

s are be

cause there i

s no

procedure is follow

ed by t

he rule

s, pai

d a heavy pri

ce, we

shoul

d learn from them, i

n strict accor

dance with the law on bi

ddi

ng and im

plementati

on ... Promise

d to give prefere

ntial policie

s for enterpri

ses,

hesitant to

cash or ca

sh not at all. Masses feel strongly about the

se issues, it i

s ne

cessary t

o be solved. T

o a

cce

lerate de

centralizati

on. S

pecifi

cation li

st list list of powers, responsi

bilities a

nd

negative, cleara

nce

, revocati

on does

not adapt to the

curre

nt situati

on of the devel

opme

nt of poli

cy documents,

espe

cially the rig

ht to admini

strative examination a

nd a

pproval

, the ca

ncellation must be

cancele

d, the

delegation must be de

centralize

d to achieve zer

o-w

ait, one- st

op,

seamless, im

prove admi

nistrative efficiency and servi

ce levels.

In parti

cula

r, the

delegation of powers must be ca

ught

properly,

never able t

o loft is no answ

er, no one care

s, ca

use

backfire, people work

harde

r. To carry out the campaign.

Crack

dow

n on law enfor

cement regulati

ons, uncivil a

nd

not as, a

s undermini

ng economic

development, such as envir

onme

ntal problems,

pay close attention to the grass-r

oots level w

eaknesses, stri

ctly investigate and dea

l with the grass-r

oots level

corr

upti

on and de

nial of Justi

ce agai

nst the intere

sts of the masses, such as corruption a

nd

corr

uption, rut

hless pe

ople ar

ound

onme

nt. In

particular, stre

ngthe

ning the construction of

Governme

nt credit, a

nd trustworthy

practice for companie

s and i

nvestors, and must not break faith with t

he

people, pr

omises a

nd the promi

se to the

society.

To buil

d a new

relationship

betwee

n Government a

nd

busine

ss. T

he

ssi

ons

General Se

cretary of

ar

d succi

nctly

summarized t

he new relationship

betwee

n Gov

ernment a

nd

business, as

pure

politi

cs, resha

ping the political relati

onship

specified i

n the

directi

on. District le

aders i

n ha

ndling

politi

cal and busi

ness relati

ons, engage i

n tradi

ng power for money, a

nd finally stumbl

ed, we

a lesson,

always kee

p in mind that

ean

ctici

ng

o

a sincere e

ngagement wit

h private enter

prise t

o hel

p solve pra

ctical

difficulties;

clarify the Division

of pow

er, exerci

sed i

n accor

dance wit

h, private e

ntrepre

neurs

with i

nnoce

nt purit

y, not abusi

ng power for per

sonal gain,

not to e

ngage in tra

ding power for money. Thir

d, in

order t

o maintain fairness a

nd justice. Fairness and justice i

s the lifeli

ne of the r

ule of la

w

, is t

he be

st devel

opme

nt environme

nt. Currentl

y, lax law enfor

cement a

nd t

he judici

al se

ctor in

our regi

on al

so exist t

o varying degrees, la

w

enforceme

nt de

partments a

nd i

ndivi

dual window units

power for

persona

l gains and bri

bes, thi

ck friends, relati

ons, human

cases, money cases i

n whi

ch seri

ously

infringe

on t

he legitimate rig

hts and i

nterests of e

nterpri

ses a

nd

pe

ople. Especially

some

law e

nforcement

and inspe

ction for pr

ofit purpose

s, deliberately l

ooki

ng for

cor

porate loophol

es, found dire

ctly under

the ti

cket does

not give

busine

ss impr

ovement

opportunities. We re

cruit a

com

pany

doesn't easily,

cultivati

ng a busi

ness more

difficult,

never for

personal gai

n, systemati

c harassment,

card,

last che

cked to

check t

o ge

t the enter

prise

coll

apse

d.

o g

uarantee t

he legitimate rig

hts a

nd i

nterests. Al

ways pr

ocee

d from the overall

situati

on

of reform and

devel

opment

of servi

ces, f

ully consider t

he

chara

cteristics of pr

oduction a

nd ma

nagement i

n non

-publi

c e

nterprises a

nd

social benefits, a

n a

ccurate grasp

of legal

limits, prote

ct the

enthusia

sm of entre

preneurs a

nd practiti

oner

s in

innovation and e

ntrepre

neurship, enhancing

expectations a

nd

confi

dence.

To pr

omote stri

ct enforceme

nt. Strengt

heni

ng law enfor

cement

procedures, impr

ove law enfor

cement

performance evaluati

on,

strengthe

ning t

he supervi

sion of law e

nforcement, ex

plorati

on a

nd pra

ctice

of risk control me

cha

nism of law e

nforceme

nt to further sta

ndardize t

he social

security,

urba

n management

, road traffic admi

nistrative law enfor

cement, effectively free, exten

sive law

-enfor

cement a

nd lax enfor

cement

of law enforcement and ot

her issues.

o

uphol

d justi

ce. Justice i

s the last li

ne of Defe

nse to

safeguard fairne

ss a

nd justice

, to unequivocall

y support the

courts and pr

ocuratorates independently exerci

se level ... Judi

cial a

ctivities were rampa

nt, must

not be

allowe

d to run, favors, money, must not be all

owe

d to knowingly vi

olate the miscarriage, vi

olations of the l

egitimate rights and interest

s of the masses must

not be allowe

d to a

buse of power, to make forest mas

s ca

n be felt in

every judicial

cases i

n e

quity and justice. Four to

dee

pen grass-r

oots

governance a

ccording t

o lawchain

do l

ong, a

nd

put scale big. To

serve the

devel

opment

of enterpri

ses. Duocuo simulta

neously impr

oving service efficie

ncy, build

better publi

c servi

ces platform, e

nha

nce

work efficie

ncy, initiative to

help

busine

sses solve the project pr

oce

dure

s, financing l

oans, issues such as land- use a

ppr

oval, reduce

operati

ng costs, busi

ness travel light a

nd e

nha

nce the confi

dence to over

come all ki

nds of dif

ficultie

s and the Foundation, real entre

prene

urial pa

ssi

on

play entrepre

ne

urshi

p, e

nha

nce t

he inter

nal vitality and

creativit

y. SI

XING an

construction, pr

omoting the rule of law, trie

s to make the transformation

of forest development XI Ge

neral Secretary stressed, to reinvigorate

Northeast China,

optimize

d devel

opme

nt environment is very important. E

nvironme

nt of rule

of law most gather M

oss, the most

conducive to

development.

Improvi

ng the lea

ding ca

dres ' usi

ng the method

of thought and the r

ule of

law Admi

nistration work,

probl

em-solving

, the ability to pr

omot

the devel

opme

nt, is t

he key to

promoti

ng the

rule

of law. The law may affect the

efficiency of out of the path of deve

lopme

nt will

be m

ore smooth,

won devel

opme

nt gains will

be sustained, a

nd

end with greater

efficiency.

Lea

ding

cadres at all level

s shoul

d take the lead in re

spe

ct of law la

w, a

bide

by,

and actively fost

er Socialist

culture

, actively

promoti

ng the field

of multi-level

governa

nce accor

ding t

o law, gui

de the

masses and consciously

abide by t

he la

w

, failing t

o find law, solve

the

problem by la

w, i

n accor

dance wit

h the

law preva

il.

XXX admi

nistration by law

of leadi

ng ca

dres

do

not exist

on t

he rul

e of la

w

, law

enforceme

nt, ca

sual

, and vow

not t

o invest

ors, t

he new scores and other turmoil. T

hese im

portant ex

positions on my distri

ct create g

ood development e

nvironme

nt with

highly

targeted and gui

dance,

especially t

he General Se

cretary pointe

d out that t

he chaos in my area al

so exist

s to varying

degree

s, some eve

n quite seri

ous. Leadi

ng ca

dres at all l

evels must improve t

he

development envir

onme

nt of rule of law as a fundamental task, a

dhere t

o the pr

oblem

oriente

d, sol

id and solve the

probl

ems in the constr

uction of rule

of law, to r

ule the

new effect for devel

opme

nt environment impr

ovements.

To hold

oup, although few i

n num

ber,

but the effect is

critical. If a local lea

ders tak

e the lead right a

ccordi

ng to law, i

n accor

dance with t

he law, the local CPPCC fresh, pragmatic and efficient

development e

nvironme

nt. Converse

ly, if a local leaders of ignoring the la

w

, impunit

y, not only t

he political e

nvironment will

be destr

oyed,

will

have seri

ous implicati

ons for the dev

elopment envir

onment. Now

, some leadi

ng ca

dres la

ck of awarene

ss on the importance of lear

ning, t

hat learn

or not

does

not matter. T

hink efficie

ncy is t

oo low too m

uch, act a

ccor

ding to t

he pr

oce

dure, t

han a

n executive

order getting al

ong wit

h. In deali

ng with complex issues, often speak of

ssue of handli

ng letters and visits, like to

spe

nd

money and buy stop a

nd

stable,

but di

sregard the law admi

nistration, in accor

dance wit

h the la

w, the r

ulechain

do l

ong, a

nd

put scale big. To

serve the

devel

opment

of enterprises. Duocuo simulta

neously impr

oving se

rvice efficie

ncy, build

better publi

c servi

ces platform, e

nha

nce w

ork efficiency, initiative to hel

p businesse

s solve t

he pr

oject

procedures, f

ina

nci

ng loa

ns, issue

s such a

s land-use a

pproval, re

duce operating

costs, busine

ss travel light and enha

nce the confide

nce t

o overc

ome all kinds of difficulties a

nd the Foundati

on, real e

ntrepre

neuri

al passion play entre

preneurship, e

nhance the internal vitality and

creativity. SI

XING an

construction, prom

oting the r

ule of la

w

, tries to make the transformation

of forest development

XI Ge

neral Secretary stre

sse

d, to reinvig

orate Nort

heast China,

optimize

d devel

opme

nt environment is very im

portant. E

nvironment of rule

of law most

gather Moss, the most conducive t

o devel

opme

nt. Improvi

ng the lea

ding

cadres '

usi

ng the method of thoug

ht and

the rule

of law Admini

stration w

ork, pr

oblem

-solving, t

he ability to pr

omote the

devel

opment, i

s the key to

promoti

ng the r

ule of law. T

he law may affect the efficie

ncy

of out

of the pat

h of devel

opme

nt will

be more sm

ooth, won devel

opme

nt gains

will be sustaine

d, and end wit

h greater efficie

ncy. Lea

ding

cadres at a

ll levels

should take t

he lea

d in respe

ct of law la

w, abi

de by, a

nd a

ctively foster Socialist

culture

, actively

promoti

ng the fiel

d of multi-l

evel gover

nance accor

ding to la

w, g

uide t

he masse

s and consci

ously

abide by the law, faili

ng to find law, solve t

he pr

obl

em by law, in a

ccordance with t

he law

prevail.

XXX admi

nistration

by law of lea

ding

cadres

do

not exist

on t

he rule

of law

, la

w enfor

cement,

casual, and vow

not to i

nvestors, the

new score

s and other turmoil. The

se important expositions

on my distri

ct create g

ood devel

opme

nt environment wit

h hig

hly targeted a

nd gui

dance, e

spe

cially the Ge

neral Secretary

poi

nted out that the chaos in my area also exists to varyi

ng degre

es,

some eve

n quite seri

ous. Lea

ding

cadre

s at all level

s must impr

ove the

devel

opment

environment

of rule of law a

s a fundame

ntal task, a

dhere t

o the

problem ori

ented,

soli

d and solve the problems i

n the

construction of rul

e of la

w, to r

ule the

new

effect for devel

opment e

nvironment impr

ovements. To hold

ders

of this group, although few in

numbe

r, but the

effect is criti

cal. If

a l

ocal l

eaders take the lea

d right a

ccordi

ng to la

w, in a

ccorda

nce with t

he la

w, the l

oca

l CPPCC fresh,

pragmatic a

nd efficie

nt devel

opme

nt envir

onment. Conversel

y, if a local lea

ders

of ignori

ng the law

, impunity,

not

only t

he political

environment w

ill be

destroye

d, w

ill have

serious impl

ications for t

he development envir

onme

nt. Now, some l

eadi

ng ca

dres la

ck of aware

ness

on t

he importance of lear

ning, that lear

n or

not

does

not matter.

Thi

nk efficiency is too l

ow too much, a

ct according to t

he pr

oce

dure, t

han

an executive

order getting al

ong

with.

In

dealing

with complex i

ssue

s, ofte

n speak of

ssue of handli

ng letters and visits, like to

spe

nd money and buy stop and

stable,

but disregard the law administration, i

n accor

dance with t

he law, the rul

２％（８２／８４）

。ＴＡＵ

检出７２例，漏诊１２例，检出率为８５．７１％（７２／８

４ ）

。ＴＶＵ

的检出率比ＴＡＵ

的检出率高。结论 ：经阴道超声对子宫腺肌病具有较高的

确诊率，

明显高于经腹超 声检查的准确度，

值得临床应用。

可对该病患者进行早诊断和早 治

疗，有利于患者的预后恢复。

治疗

2.1

药物治疗

我们认为子宫腺肌症的异位 内膜一般来源于基底层子宫内膜。

且子宫腺肌病

患者腹痛和月经 关系很密切

,

绝经后消失

,

明

[7],

子宫腺肌病的病灶中存在

ER

、

PR

、

AR

等多种激素受体

,

且

ER

AR

的表达显著高于

原 位内膜

,

说明子宫腺肌病与雌激素作用存在一定关系。因此在治 疗方面可应用能降低雌激

素水平的药物。年轻有生育要求，近绝经期，不接受手术或保守 性手术治疗后症状复发者

,

可考虑药物治疗。

< br>

2.1.1

雄激素类衍生物

2.1.1.1

达那唑

抑制

FSH

、

LH

峰值行成；抑制卵巢甾体激素生成，增加雌、孕激素代谢 ；

直接与子宫内膜雌、

孕激素受体结合抑制内膜细胞增生，

最终导致内膜萎缩，出现闭经。称

为假绝经疗法。

< br>治疗期间痛经可消失，

停药后会复发。

用法：

次，

2~3

次

/

日，

持续

6

个月。副反应主要有乳房缩小，体重增加，痤疮，皮脂 增加，多毛，声音改变，头痛，性欲

减退等，但发生率较低。

2.1.1.2

孕三烯酮

有抗孕激素中度抗雌激素和抗性腺效应，能增加游离睾酮含量 ，减少性

激素结合球蛋白水平，抑制

FSH

、

LH

峰值形成，减少

LH

均值，使体内雌激素水平下降，

异位内膜萎缩、吸收，也是一种假绝经疗法。用法：

2.5mg/

次，

2

次

/

周，

6

个月为一疗程。

副反应发生率同达那唑，但程度略轻。