褚春芳 吴玉梅

    [摘要] 子宫肌瘤会对生育造成影响，肌壁间子宫肌瘤即使没有宫腔受压，也可通过引起子宫异常蠕动与收缩、影响子宫内膜的形态与功能等方式对妊娠造成负面影响。目前国内外对有生育要求的无症状无宫腔受压肌壁间子宫肌瘤的处理尚无一致的指南推荐，应根据患者的年龄、肌瘤的大小和位置等情况采取个体化的治疗方案，其中直径≥4 cm的肌壁间子宫肌瘤行手术剔除可能有助于提高妊娠率。

    [关键词] 子宫肌瘤;妊娠率;不孕症;子宫内膜容受性

    [中图分类号] R737.33? ? ? ? ? [文献标识码] A? ? ? ? ? [文章编号] 1673-7210(2019)08(c)-0047-04

    [Abstract] Uterine fibroids can affect fertility. Intermural uterine fibroids， even without uterine pressure， can negatively affect pregnancy by causing abnormal peristalsis and contraction of uterus and affecting the morphology and function of endometrium. At present， there is no consistent recommendation for the treatment of asymptomatic and non-uterine intramural myoma with fertility requirements at home and abroad. Individualized treatment should be adopted according to the patient′s age， size and location of the myoma. Surgical removal of the intramural myoma with diameter greater than 4 cm may help to improve the pregnancy rate.

    [Key words] Uterine fibroid; Pregnancy rate; Infertility; Endometrial receptivity

    子宫肌瘤是育龄女性最常见的良性肿瘤，也是影响女性生殖健康的常见病，其累积发病率约占育龄女性的25%[1] ......