據統計,大約20%以上的女性都有子宮肌瘤的困擾,在罹患子宮肌瘤的族群中,有超過半數的人雖患有子宮肌瘤,卻毫無症狀,
因此有些人終其一生都不知道自己的子宮長肌瘤。不過,患者對於子宮肌瘤的警覺,其實與肌瘤的大小與生長位置有很大的關係。
今天,潘院長來跟大家聊聊這常見的婦女疾病之一:子宮肌瘤。
子宮肌瘤患者多見於30歲以上的女性,子宮會長肌瘤是因為子宮內膜的細胞、組織生長的方向錯誤,原本該往子宮腔生長的組織 細胞,轉而往子宮肌肉層生長,造成肌肉細胞增生形成的良性腫瘤。
女生經痛的原因有很多,包括卵巢功能異常、荷爾蒙分泌異常、生活作息不正常及心理壓力等,都有可能引發,若經常有嚴重且頻繁 的經痛,就要特別注意了,這極有可能是疾病發出的警訊,其中以子宮肌瘤最為常見。許多女性認為經痛是正常的生理現象,其實最還是由醫師做進一步的檢查才能釐清經痛的原因。
幾乎99.9%的子宮肌瘤都是良性的,且良性通常不會變成惡性。惡性的子宮肌瘤佔極少數,且惡性腫瘤一開始的發展態勢就會非常地兇猛,進展得也非常快,還會迅速的出血、疼痛, 絕對不讓患者有喘息的餘地。
要怎麼判斷子宮是不是長肌瘤呢?最簡單、直接且正確的方法就是到婦產科做腹部超音波檢查,不需要做電腦斷層,也不必照MRI,透過腹部超音波檢查,醫生可以很明確的做出診斷。
1. 不正常出血 / 這是最直接且最具代表性的症狀,此外像是經期延長、經血量多、周期縮短、但有大量血塊、不規則出血、白帶增多、經期點狀出血等也很常見。
2. 經痛 / 經痛分成原發性與次發性,比較常見的是原發性,通常會伴隨年齡或生育後逐漸改善;次發性通常是器質性病變,常見的是子宮內膜異位症與子宮肌瘤,包含子宮肌瘤與子宮肌腺瘤。
3. 腫塊 / 當腫瘤長到一定大小時,用手觸摸下腹部即可發現,通常肌瘤若不是長到像拳頭大,從身體表面是觸摸不到的,尤其有些肥胖女性腹部脂肪很厚,很難經由觸診發現。
4. 腹痛與頻尿 / 當子宮肌瘤過大而壓迫到周圍組織時,下腹部會有壓迫感,繼而出現腹痛、頻尿、 排尿困難、便秘等症狀,也可能出現不明原因的腰酸背痛。
5. 影響受孕與不孕 / 若肌瘤位置長在子宮頸口、陰道附近,使精子無法順利進入子宮,或者因子宮肌瘤造成輸卵管不正常移動,影響到精子的運行及不正常出血,則會使不孕及自然流產機率增加。
6. 慢性骨盆腔疼痛 / 當子宮肌瘤長得太大,可能會造成骨盆腔充血或是子宮組織壞死,進而造成骨盆腔慢性疼痛。
7. 貧血 / 因月經來時身體會大量流失血液而造成貧血,出現如心悸、呼吸急促、易疲勞、臉色蒼白等情況。
子宮肌瘤發生的位置與大小因人而異,因此治療方式的評估也不相同。
九成以上的子宮肌瘤是良性的, 如果尺寸不大,患者也沒有不適症狀,只需定期追蹤,但若嚴重影響到生育計畫及生活機能,且肌瘤異生長,有變成惡性的疑慮時,則需由專業醫師做定期追蹤評估,嚴重時需予以切除治療。
一般來說,沒有症狀或是較小的子宮肌瘤,通常不需要開刀,可暫時用藥物控制 ; 若是經血 過多、嚴重經痛,而且藥物控制無法改善的時候,才會建議患者接受手術治療。
1.單純肌瘤摘除術 / 對於還需要保留生育能力的患者,應盡可能避免摘除子宮,而施行只摘除肌瘤的肌瘤剝離手術,不過這種方法要依肌瘤的大小及生長位置而定,有時是不可行的。
2.全子宮切除術 / 肌瘤對周圍器官產生壓迫,出現嚴重的下腹痛,或者因月經量過多、異常出血等造成明顯的貧血症狀,一般需進行將肌瘤和子宮一併切除的全子宮切除術,但原則上,除高齡女性以外,盡可能考慮不切除卵巢,以保留正常的女性機能。
3.次全子宮切除術 / 就是切除子宮體,但保留子宮頸及卵巢。對於子宮良性疾病,且排除子宮頸病變的情況下,選擇保留正常的子宮頸組織,對調節女性內分泌、保持骨盆腔底部張力具有要作用,同時因為子宮頸有分泌黏液的功能,對保持陰道酸鹼度、預防陰道菌群紊亂有好處。要注意的是,施行保留子宮頸的次子宮切除術,子宮頸殘端癌變的發生率為 0.2% ~ 1% ,且再次手術的難度增加,這是保留子宮頸手術最大的問題,患者術後必須做定期追蹤檢查。
隨著醫療科技的進步、器械材料的改良、技術的突破以及手術經驗的累積,腹腔鏡微創手術在很多手術治療方面已逐漸取代傳統開腹手術,成為標準的治療方式;目前已在婦科上廣泛應用,做結紮、子宮肌瘤 / 子宮內膜異位症等手術,因手術傷口小(僅需開二至四個僅半公分大小的傷口)、恢復期快,術後疼痛感小, 目前已逐漸成為診治主流,深獲院內診治患者好評。
潘俊亨醫師為 愛麗生婦產科院長,潘醫師對於子宮肌瘤手術與治療的專業,廣受好評。
其著作《經痛背後有惡魔》更是幫助全國女性認識子宮內膜異位、巧克力囊腫、子宮肌腺瘤、子宮肌瘤及卵巢囊腫的一本好書。
愛麗生提供更完善的線上服務,有任何相關疑問的女性朋友,請點擊加入好友,啟用免費諮詢。

*****
*****
加油,別放棄,我們的星球,是變動的,生老病死,喜怒哀樂,生命 生生不息。 知足常樂。 很多國家,現在溫度,正+40度 或 負-40度, 生 活 和 生存,非常艱辛。 --- 蘇+澳+後勤+某某部,也曾 酒後駕車,BMW,車頭全毀,引擎噴飛,人沒事,上過頭條新聞,網路可以查尋到。(上新聞) 該某某部,還發生過,特別案件,因老婆,無照駕駛,老公軍人,跑去夥同鄰居,製造假車禍,真詐保險公司,雖然後來,心裡不安,主動告知,保險公司,還是被,警方發現,移送地檢署偵辦。(沒上新聞) 不知道,今年 還是去年,某艦9+3+7,有士兵,去淡水遊玩,因薪俸較低,且薪俸運用和理財不佳,到賣場超市,偷竊一盒保險套。(就算船號記錯,內容不會錯,因為是,公開場合,全體宣導,注意事項)(沒上新聞) --- 蘇+澳,南+方+澳。 社區、營區,真糟糕。 普悠瑪出軌事件、大橋斷裂事件、海軍伊清楓事件。 --- 請強化,資訊安全,駭客已經厲害到,可以入侵手機,啟動與關閉軟件,並監視手機與盜取圖片和資料,造成用戶的錯覺,刻意制造出,手機用戶,幻想 或 精神病。 利益與衝突,攏斷與掌控。 --- 刮刮樂,上面號碼,應該以, 發型款版本,進行編碼, 後面則以,發行張數量,進行編碼。 ABC-1234567(款式-張數) 不然誰知道,到底有沒有,少印 或 多印。 --- 支持公益彩卷。有錢的話,當然會幫助需要的人。 請上架,因賠錢,而下架的,樂線九宮格,謝謝。 請20:00封盤,20:05開獎。(20:30開獎,理由是,需要計算,消售金額,騙三歲小孩喔) --- 一個、謊言、炒作、洗腦...的世界。 早就已經,沒有什麼,商品供需了,所以才會造成,大家沒什麼收入。(大家在比氣長,看誰食物多) 全世界都相同問題,所以才會打,貿易戰。(太平洋 魚獲 和 工作機會) 食物,才是真的(王道),其它都是假的! --- 經濟好壞? 大家,房貸額度用光、信貸額度用光、信用卡額度用光、商品沒供需 股票炒不起來、虛擬貨幣 假的上上下下。(負債累累) 只能說,以前買到房屋 或 擁房者,已經 還清債務的人,才是幸福的。(低房價) 以前是,(慢調生活),(農業時代),(相互競爭少),(人人有田),(人人有房),現在反過來了。 --- (洗腦兼爛權 的 學長學弟制 軍隊)槽糕到不行。 --- (玩弄人、貪汙,事件永無止息),(滅證洩責,第一名),(商業值供獻零),(只會從國庫,透過預算,拿老百姓,繳的稅收,進行揮霍) [基層工人,跟老百性相同,還比較有,供獻價值] --- Come on, don't give up, our planet is changing, with birth, old age, sickness and death, joy, anger, sorrow and joy, and life is endless. Contentment is always happy. In many countries, the current temperature is positive +40 degrees or negative -40 degrees. It is very difficult to live and survive. --- Su + Australia + logistics + XX department, also once drunk driving, BMW, the front of the car was completely destroyed, the engine was flying, people were okay, the headlines can be found on the Internet. (On the news) There have also been special cases involving his wife, unlicensed driving, husband and soldier. They went to work with neighbors, made fake car accidents, and scam the insurance company. Although later, he was uneasy, he voluntarily informed the insurance company. , The police found it and transferred it to the Prefectural Procuratorate for investigation. (Not in the news) I don't know, this year or last year, a certain ship 9+3+7, there are soldiers, go to Danshui to play, because the salary is low, and the use of salary and financial management are not good, go to the supermarket and steal a box of condoms. (Even if the ship number is wrong, the content will not be wrong, because it is, public occasions, all publicity, precautions) (not on the news) --- Su + Australia, South + Fang + Australia. The community, the camp, it's really bad. Puyuma derailment incident, bridge fracture incident, navy Yiqingfeng incident. --- Please strengthen information security. Hackers are already powerful enough to invade mobile phones, start and close software, monitor mobile phones and steal pictures and data, causing users to misunderstand, deliberately creating, mobile phone users, fantasy or mental illness. Interests and conflicts, severance and control. --- Scratch music, the number above should be, Hair style version, coded, After that, the number of issued sheets is used for coding. ABC-1234567 (style-number of sheets) Otherwise, who knows, whether there is less printing or more printing. --- Support charity rolls. If you have money, you will certainly help those in need. Please put it on the shelf, because it lost money, and it was taken off, Lexian Jiugongge, thank you. Please close the plate at 20:00 and draw at 20:05. (The lottery is drawn at 20:30, the reason is that it needs to be calculated, the amount of sales, to cheat a three-year-old child) --- A world of lies, hype, brainwashing... It has been long since, there is nothing, commodity supply and demand, that's why everyone has no income. (Everyone is getting angry, see who has more food) The world has the same problem, so it will fight a trade war. (Pacific Fish Catch and Job Opportunities) Food is real (king way), everything else is fake! --- Is the economy good or bad? Everyone, the mortgage line is used up, the credit line is used up, the credit card line is used up, there is no supply and demand for goods, stocks cannot be speculated, and virtual currencies are going up and down. (Large debts) It can only be said that those who have bought or owned a house before and who have paid off their debts are happy. (Low house price) It used to be, (slow life), (agricultural age), (less competition), (everyone has a field), (everyone has a house), but now it’s the other way around. --- (Brainwashing and ruined power of the senior schoolmate system army) Too bad. --- (Playing with people, embezzlement, the incident never ends), (Extinguish evidence and venting responsibility, the first place), (Commercial value for zero), (Only from the national treasury, through the budget, the tax paid by the people and the tax will be squandered) [Grass-roots workers are the same as Lao Bai, but they are more valuable, offering value] ---
關閉系統基哨站。 這個世界,只不過是,謊言支撐起來,當一切改變時,別期待 國家 與 政府 或 任何人的承諾,因為 生死,都隨時存在,只是人類體型放大化,且記憶裡 存在著,安全思想,比較多一些生存而已。 沒有供需,一切都是假的,只是透過 各種手段 與 職業,獲取 等值的證明,紙鈔 與 錢幣。 所以生存概論,推翻政權 或 加入集團組織。 This world is just supported by lies. When everything changes, don’t expect the promise of the state, the government or anyone, because life and death exist at any time, but the size of human beings is enlarged, and there is in memory, safety thoughts, comparisons Survive more. There is no supply and demand, everything is fake, just through various means and occupations, to obtain proof of equivalent value, banknotes and coins. So an introduction to survival, overthrow the regime or join a group organization.
一個錯誤的選擇 一個錯誤的環境 造就了 一連串 錯誤的事件 軍隊 隸屬 特殊環境 , 官員有責 解決底下問題, 否則沒資格 命令 不要只會 , 升官發財 , 滅證卸責, 受傷死亡, 都不算數, (該死的軍隊)(管理極差) [該休息 休息][該工作 工作] [很困難?] (作息時間,與外面社會,稍微不同,當然正常) (部隊管理不佳, 造成他人精神壓力問題) (部隊管理不佳 ,造成他人工作負荷過重) (部隊管理不佳,造成 軍職 約聘, 捉弄 與 陷害 他人, 永久上的紀錄遺憾) (受傷沒說,完全不算數)(內傷算自己該死) (卸責厲害的軍隊) ( 上電視、上報紙、莒光園地、女兵日記 ) (形象 洗白 第一名) A wrong choice A wrong environment Created a series of wrong events The army is in a special environment, and officials have the responsibility to solve the underlying problems, otherwise they are not qualified to order Don't just get promoted and get rich, destroy evidence and shirking responsibility, Injuries and deaths don’t count, (damn army) (very poor management) [Should take a break] [This job should work] [It’s difficult?] (The work and rest time is slightly different from the outside society, of course it is normal) (Poor management of the troops, causing mental stress to others) (Poor management of the troops, resulting in excessive workloads for others) (Poor management of the troops, resulting in military appointments, teasing and framing others, permanent record regrets) (I didn't say the injury, it doesn't count at all) (Internal injury counts as one's own damn) (Short the blame for the powerful army) (On TV, Newspaper, Juguang Garden, Female Soldier's Diary) (Image whitewashing first place)