子宮內膜異常增生的手術後如何治療？-婦產科

子宮內膜異常增生？

醫生你好，我想請問我平常月經量很大，尤其是前三天用41公分衛生棉有時候不到半小時整片都滿若是在睡覺半夜需要頻繁起來而且會大量到衛生棉吸不住這是我近期做到子宮內膜手術報告，在這個手術前一年我也做過一次那次血色素剩下6而已，這次去驗血色素剩8，有去看診，但是醫生說叫我吃避孕藥來控制，我想請問到底有沒有什麼辦法可以改善或是建議的一勞永逸方法，因為這兩個手術日期大概就是一年需要手術一次
［1］SNOMED: 00003-A-M80000 PATHOLOGIC DIAGNOSIS: Uterus, endometrium, fractional D ＆ C ---endometrium at secretory phase (no hyperplasia found) GROSS: The specimen consists of more than ten tan to red and soft formalin fixed tissue fragments, measuring 3.3 x 3.3 x 0.7 cm in aggregate. The specimen is totally submitted in two cassettes. MICROSCOPIC: The sections show secretory-phase endometrium composed of tortuous glands with luminal secretion and predecidualized stroma. No evidence of endometrial hyperplasia is found. Please correlate clinically.
［2］SNOMED: 00003-A-M80000 PATHOLOGIC DIAGNOSIS: Uterus, endocervix, curettage---scant endocervical tissue present GROSS: The specimen consists of many pieces of red and soft formalin fixed tissue fragments, measuring 0.7 x 0.4 x 0.3 cm in aggregate. The specimen is totally submitted in one cassette. MICROSCOPIC: This section shows scant endocervical tissue present in a background of blood, fibrin material, and mucus. No specific pathological finding is found.
［3] SNOMED: 00003-A-M80000PATHOLOGIC DIAGNOSIS: Uterus, endometrium, fractional D ＆ C ---endometrium at secretory phase (no hyperplasia found)GROSS: The specimen consists of more than ten tan to red and soft formalin fixed tissue fragments, measuring 3.3 x 3.3 x 0.7 cm in aggregate. The specimen is totally submitted in two cassettes.MICROSCOPIC: The sections show secretory-phase endometrium composed of tortuous glands with luminal secretion and predecidualized stroma. No evidence of endometrial hyperplasia is found. Please correlate clinically.
[4] M80000PATHOLOGIC DIAGNOSIS: Uterus, endometrium, fractional D ＆ C ---endometrium at secretory phase (no hyperplasia found)GROSS: The specimen consists of more than ten tan to red and soft formalin fixed tissue fragments, measuring 3.3 x 3.3 x 0.7 cm in aggregate. The specimen is totally submitted in two cassettes.MICROSCOPIC: The sections show secretory-phase endometrium composed of tortuous glands with luminal secretion and predecidualized stroma. No evidence of endometrial hyperplasia is found. Please correlate clinically.
2023/3/22
SNOMED: 00003-A-M80000 PATHOLOGIC DIAGNOSIS: Uterus, endocervix, curettage: Blood clots, squamous epithelium with few endocervical tissue. GROSS: The specimen consists of many pieces of brown and soft formalin fixed tissue fragments, measuring 1.2 x 1.0 x 0.2 cm in aggregate. The specimen is totally submitted in one cassette. MICROSCOPIC: Section shows blood clots, squamous epithelium with few endocervical tissue.
（2）SNOMED: 00003-A-M80000 PATHOLOGIC DIAGNOSIS: Uterus, endocervix, curettage: Blood clots, squamous epithelium with few endocervical tissue. GROSS: The specimen consists of many pieces of brown and soft formalin fixed tissue fragments, measuring 1.2 x 1.0 x 0.2 cm in aggregate. The specimen is totally submitted in one cassette. MICROSCOPIC: Section shows blood clots, squamous epithelium with few endocervical tissue.

小嘉，30~39歲女性，詢問日期：2024/10/24

劉馥萍醫師回覆-婦產科

醫事人員經歷：衛生福利部基隆醫院婦產科主治醫師

您好建議回診與您的主治醫師討論是否需要調整治療用藥或其他手術謝謝

回覆日期：2024/10/24
資料來源：台灣e院 - 子宮內膜異常增生

彙整補充說明

子宮內膜異常增生是一種常見的婦科疾病，通常會導致月經不規則、經量過多或不正常出血等症狀。
根據您的描述，您在手術後仍然面臨著月經量過多的問題，這可能與子宮內膜的狀態有關。
手術後的治療和管理通常需要根據個別情況進行調整。

首先，您提到的手術報告顯示您的子宮內膜在分泌期，且沒有發現增生的跡象，這是一個好消息。
這意味著目前的內膜狀態是正常的，並且不會直接導致癌變。
然而，您仍然經歷著大量出血的問題，這可能與荷爾蒙失調有關。
醫生建議您使用避孕藥來控制月經量，這是一種常見的治療方法，因為避孕藥可以調節荷爾蒙水平，減少月經出血量。

除了避孕藥，還有其他一些治療選擇可以考慮。
例如，若您的症狀持續或加重，醫生可能會建議進一步的檢查或治療，如使用黃體素或其他荷爾蒙療法來幫助調整內膜的生長。
此外，對於某些患者，可能會考慮進行子宮內膜消融術，這是一種可以減少或消除月經出血的手術。

在手術後的恢復期間，您需要注意以下幾點：
1. 定期回診：定期回診可以讓醫生監測您的恢復情況，並根據需要調整治療方案。

2. 觀察症狀：如果出現異常出血、劇烈腹痛或其他不適，應立即就醫。

3. 生活方式調整：保持健康的生活方式，包括均衡飲食、適度運動和充足的休息，這些都有助於改善整體健康狀況。

4. 心理支持：面對持續的健康問題，心理壓力可能會增加，尋求心理支持或參加支持小組可能會有所幫助。

最後，對於您提到的“一勞永逸”的解決方案，這在醫學上是相對困難的，因為每個人的身體狀況和反應都不同。
持續的醫療跟進和適當的治療調整是管理這種情況的關鍵。
建議您與主治醫師深入討論，尋找最適合您的治療方案，並了解可能的長期管理策略。
希望您能早日找到合適的解決方案，改善您的健康狀況。