«上一篇/Previous Article|本期目录/Table of Contents|下一篇/Next Article»

《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

25卷

期数:

2019年01期

页码:

73-76

栏目:

临床医学

出版日期:

2019-01-20

文章信息/Info

Title:

Comparison of efficacy between autocoagulative endometrial ablation and transcervical resection of endometrium for perimenopausal dysfunctional uterine bleeding

文章编号:

1006-8147(2019)01-0073-05

作者:

何咏梅; 张惠敏; 谢海燕

（河南省许昌市建安区人民医院妇产科，许昌461000）

Author(s):

HE Yong-mei;  ZHANG Hui-min;  XIE Hai-yan

（Department of Obstetrics and Gynecology, Jian’an District people’s Hospital, Xuchang City, Henan Province, Xuchang 461000, China）

关键词:

自凝刀子宫内膜射频消融术; 宫腔镜子宫内膜电切术; 围绝经期; 功血

Keywords:

radiofrequency ablation;  hysteroscopictranscervical resection of endometrium;  perimenopause;  dub

分类号:

R711.52

DOI:

-

文献标志码:

A

摘要:

目的：比较自凝刀子宫内膜射频消融术（BBT）与宫腔镜子宫内膜电切术（TCRE）治疗围绝经期功血的临床效果。方法：选取2015年5月-2016年12月在河南省许昌市建安区人民医院妇产科接受治疗围绝经期功血的患者96例，采用随机数字法分为对照组和观察组，每组患者各48例。对照组患者运用宫腔镜子宫内膜电切术治疗，观察组患者运用自凝刀子宫内膜射频消融术治疗。比较两组患者的临床疗效、治疗前后性激素水平、子宫内膜厚度、治疗前后血红蛋白水平、术中情况、住院时间及并发症情况。结果：观察组患者的总有效率为98%，对照组患者总有效率为94%，两组患者总有效率比较，差异无统计学意义（P>0.05）。两组患者性激素包括促卵泡激素（FSH）、促黄体素（LH）、睾酮（T）、催乳素（PRL）、孕酮（P）及雌二醇（E2）水平在治疗前、治疗后均无统计学差异（P>0.05）。 观察组患者术中出血量、手术时间及住院天数分别为（10.36±6.03）mL、（12.64±2.64）min、（2.15±1.29）d优于对照组（26.26±8.16）mL、（22.61±3.61）min、（3.64±1.74）d，差异有统计学意义（P<0.05）。观察组患者术后出血、发热等并发症发生率为2.08%低于对照组14.58%，差异有统计学意义（P<0.05）。两组患者治疗前子宫内膜厚度和血红蛋白水平比较无统计学差异（P>0.05）。观察组患者治疗后子宫内膜厚度[（3.49±0.97）mm]薄于对照组[（5.21±1.24）mm]，患者治疗后，血红蛋白[（121.37±8.04）g/L]高于对照组[（101.51±10.28）g/L]（P<0.05）。结论：自凝刀子宫内膜射频消融术对围绝经期功能失调性出血疗效显著，恢复快、安全性高，对患者的内分泌激素水平无明显影响，值得临床推广应用。

Abstract:

Objective: To compare the clinical effects of autocoagulant endometrial radiofrequency ablation (BBT) and hysteroscopic endometrial resection(TCRE) in the treatment for peri-menopausal dysfunctional blood. Methods：Selected from May 2015 to December 2016 in henan province sussing out district people’s hospital of obstetrics and gynecology，96 patients were treated with menopausal transition of function by the random number method and the patients were divided into control group and observation group (n = 48).Patients in the control group were treated with hysteroscopic endometrial electrotomy, and patients in the observation group were treated with auto-coagulation knife endometrial radiofrequency ablation. The clinical efficacy, sex hormone levels before and after treatment, endometrial thickness, hemoglobin levels before and after treatment, intraoperative conditions, hospitalization time and complications of the two groups were compared. Results：The total effective rate of patients in the observation group was 98%, and the total effective rate of patients in the control group was 94%. The difference between the two groups was not statistically significant (P>0.05). There was no significant difference in the levels of sex hormones between the two groups, including follicle stimulating hormone (FSH), luteinizing hormone (LHN), testosterone (TX), prolactin (PRL), progesterone (P) and estradiol (E2) before and after treatment (P>0.05). The amount of intraoperative bleeding, operation time and hospital stay in the observation group were （10.36 ±6.03）mL / min, （12.64 ±2.64） / min/d and （2.15 ±1.29）/ d, respectively, which were significantly higher than those in the control group（26.26±8.16）mL，（22.61±3.61）min and（3.64±1.74） d, respectively (P<0.05). The patients in the observation group had postoperative bleeding. The incidence of complications such as fever was 2.08% lower than that of the control group (14.58%, P<0.05). There were no significant differences in endometrial thickness and hemoglobin levels between the two groups before and after treatment (P> 0.05). The endometrial thickness was（3.49±0.97） mm after treatment in the observation group. It was thinner than that in the control group (5.21±1.24) mm after treatment. The hemoglobin level was （121.37±8.04） g/L higher than that in the control group（101.51±10.28）g/L(P<0.05). Conclusion:The curative effect of auto-congealing knife endometrial radiofrequency ablation for perimenopausal dysfunctional tonal hemorrhageis distinct, with rapid recovery, high safety, and hasno obvious effect on the patient’s level of endocrine hormone, which is suitable for clinical popularization and application.

参考文献/References:

[1] 王林蝶, 任国秀, 张效兰, 等. 超声引导自凝刀结合中药治疗功能性子宫出血的效果观察[J].中国初级卫生保健, 2016, 30(3):31
[2] 钟小渺, 谭骥. 自凝刀射频消融联合米非司酮治疗更年期顽固性功血的疗效观察[J].医学临床研究, 2016, 33(3):591
[3] 乐杰. 妇产科学[M]. 7版.北京:人民卫生出版社， 2008:312-313
[4] 杨舒萍, 廖建梅, 陆志红, 等.射频消融治疗子宫疾病181例分析[J].齐齐哈尔医学院学报, 2014, 35(6):831
[5] 唐桂清. 射频消融术治疗子宫功能性出血的临床应用价值[J]. 中国继续医学教育, 2015, 9(9):75
[6] 陈志刚, 吕燕, 何艳, 等. 宫腔镜电切术中机械性预处理治疗难治性功能失调性子宫出血的效果分析[J]. 医学综述, 2016, 22(10):2067
[7] 李焱, 钟彦培, 布占红, 等. 宫腔镜下子宫内膜电切术治疗围绝经期功血对内分泌激素的影响[J].辽宁医学院学报, 2015, 4(4):60
[8] 杨九红.宫腔镜下子宫内膜电切术治疗围绝经期功血临床效果及对内分泌激素的影响[J].河南医学研究, 2016, 25(7):1294
[9] 梁茹英.子宫内膜电切术治疗功能性子宫出血后的内分泌激素变化探讨[J]. 中国医药导刊, 2014, 1(1):27
[10] 吴爱华,汤飒爽.自凝刀射频消融术治疗功能失调性子宫出血180例[J]. 浙江中西医结合杂志, 2014, 5(8):701
[11] Neuwirth R S,Loffer F D,TrenhaileT,etal.The incidence of endometrial cancer after endometrial ablation in a low risk population[J]. J Am Assoc GynecolLaparosc, 2014, 11(4):92
[12] 杨江华, 张丹丹, 高琴, 等. 宫腔镜子宫内膜射频消融术治疗围绝经期功血疗效观察[J]. 中国性科学, 2016, 25(11):36
[13] 吴会玲, 王力, 巩李娜.宫腔镜下子宫内膜电切术对围绝经期功血患者内分泌激素的影响[J].检验医学与临床, 2015, 12(5):661
[14] 余丹.宫腔镜电切术联合米非司酮治疗围绝经期功能失调性子宫出血92例[J].中国药业, 2014, 23(5):73
[15] Cooper J,Gimpelson R J.Summry of safety and effectiveness data from FDA:a valuable source of information on the performance of global endometrial ablation devices[J]. Reprod Med, 2014, 49(4):267

相似文献/References:

备注/Memo

备注/Memo:

作者简介 何咏梅（1976-），女，副主任医师，学士，研究方向：妇产科；E-mail: sun1561775@163.com。

常用功能

更新日期/Last Update: 2019-03-01