12/03/2026
什么情况下需要做“子宫切除”?
门诊中常常有患者问:
“医生,我是不是一定要把子宫拿掉?”
其实,子宫切除在妇科手术中并不少见。但子宫是女性重要的生育器官,是否需要切除,一定要根据疾病类型、年龄以及生育需求综合评估。
一般来说,医生会在以下情况考虑子宫切除:
① 良性疾病
子宫肌瘤:肌瘤较大或多发,导致严重月经过多、疼痛或压迫症状
子宫腺肌病:严重痛经、月经异常,药物治疗无效
子宫内膜不典型增生:存在一定恶变风险
宫颈高级别病变:尤其绝经后或病变范围较大
卵巢肿瘤:部分患者需要同时切除子宫及附件
② 恶性疾病
子宫内膜癌
卵巢癌
宫颈癌
这类情况往往需要手术治疗,以达到根治或控制疾病的目的。
重要的是:
如果患者年轻或仍有生育需求,很多情况下可以选择保留子宫的治疗方案,例如肌瘤剔除、宫腔镜手术或保守治疗。
每一位患者的情况都不同,
治疗方案一定是个体化的。
医学不仅是治疗疾病,
也要尽可能保护女性的身体与未来。
12.3.2026
刘宜耀医生
When Is a Hysterectomy Necessary?
In the clinic, patients often ask:
“Doctor, do I really need to have my uterus removed?”
In reality, hysterectomy is not uncommon in gynecological practice. However, the uterus is an important reproductive organ for women. Whether it should be removed depends on several factors, including the type of disease, the patient’s age, and her desire for future fertility.
Generally, doctors may consider a hysterectomy in the following situations:
1️⃣ Benign Conditions
Uterine fibroids: Large or multiple fibroids causing heavy menstrual bleeding, significant pain, or pressure symptoms.
Adenomyosis: Severe menstrual pain and abnormal bleeding that do not respond to medical treatment.
Atypical endometrial hyperplasia: A condition with a risk of progressing to cancer.
High-grade cervical lesions: Especially in postmenopausal women or when the affected area is extensive.
Ovarian tumors: In some cases, removal of the uterus together with the ovaries and fallopian tubes may be recommended.
2️⃣ Malignant Conditions
Endometrial cancer
Ovarian cancer
Cervical cancer
In these situations, surgery is often necessary to achieve cure or control of the disease.
Importantly:
For women who are young or still wish to have children, uterus-preserving treatments may sometimes be considered, such as fibroid removal (myomectomy), hysteroscopic procedures, or conservative medical therapy.
Every patient is unique, and treatment decisions should always be individualized.
Medicine is not only about treating disease,
but also about protecting a woman’s body and her future whenever possible.
12.03.2026
DR LAU NGEE YIN