国际妇产科学杂志
國際婦產科學雜誌
국제부산과학잡지
JOURNAL OF INTERNATIONAL OBSTETRICS AND GYNECOLOGY
2014年
5期
526-530
,共5页
马宁%夏恩兰%赵玉婷%郭艳
馬寧%夏恩蘭%趙玉婷%郭豔
마저%하은란%조옥정%곽염
子宫出血%子宫内膜异位症%子宫腺肌病%子宫内膜去除%诺舒
子宮齣血%子宮內膜異位癥%子宮腺肌病%子宮內膜去除%諾舒
자궁출혈%자궁내막이위증%자궁선기병%자궁내막거제%낙서
Uterine hemorrhage%Endometriosis%Adenomyosis%Endometrial ablation%NovaSure
目的：评估第二代子宫内膜去除术诺舒（NovaSure）的安全性和有效性，对术后随访结果进行疗效分析。方法：对2011年1月-2013年12月，在首都医科大学附属复兴医院宫腔镜中心使用诺舒治疗的70例异常子宫出血（AUB）患者，记录病情、手术前后血红蛋白、子宫内膜厚度、手术情况和术后随访症状改善情况。结果：①患者年龄28～54岁，平均（43.5±5.5）岁，有严重内科合并症者占27.1%（19/70），子宫长度（9.17±1.12）cm，诺舒主机工作时间55～179 s，平均（122.00±19.73）s，术时出血均小于10 mL；所有患者均未发生并发症。②随访闭经率54.3%（38/70），有效率97.1%（68/70），再次手术率2.9%（2/70），宫腔积液率28.6%（20/70）。③术前与术后3个月血红蛋白（98.56 g/L vs.115.27 g/L）及子宫内膜厚度（9.2 mm vs.3.4 mm）差异有统计学意义（均P=0.000）。④子宫腺肌病与非子宫腺肌病患者诺舒治疗后闭经率差异有统计学意义（χ2=6.860，P=0.013）。结论：诺舒子宫内膜去除术治疗异常子宫出血安全、有效、疗效显著；子宫腺肌病可能是影响疗效的因素。
目的：評估第二代子宮內膜去除術諾舒（NovaSure）的安全性和有效性，對術後隨訪結果進行療效分析。方法：對2011年1月-2013年12月，在首都醫科大學附屬複興醫院宮腔鏡中心使用諾舒治療的70例異常子宮齣血（AUB）患者，記錄病情、手術前後血紅蛋白、子宮內膜厚度、手術情況和術後隨訪癥狀改善情況。結果：①患者年齡28～54歲，平均（43.5±5.5）歲，有嚴重內科閤併癥者佔27.1%（19/70），子宮長度（9.17±1.12）cm，諾舒主機工作時間55～179 s，平均（122.00±19.73）s，術時齣血均小于10 mL；所有患者均未髮生併髮癥。②隨訪閉經率54.3%（38/70），有效率97.1%（68/70），再次手術率2.9%（2/70），宮腔積液率28.6%（20/70）。③術前與術後3箇月血紅蛋白（98.56 g/L vs.115.27 g/L）及子宮內膜厚度（9.2 mm vs.3.4 mm）差異有統計學意義（均P=0.000）。④子宮腺肌病與非子宮腺肌病患者諾舒治療後閉經率差異有統計學意義（χ2=6.860，P=0.013）。結論：諾舒子宮內膜去除術治療異常子宮齣血安全、有效、療效顯著；子宮腺肌病可能是影響療效的因素。
목적：평고제이대자궁내막거제술낙서（NovaSure）적안전성화유효성，대술후수방결과진행료효분석。방법：대2011년1월-2013년12월，재수도의과대학부속복흥의원궁강경중심사용낙서치료적70례이상자궁출혈（AUB）환자，기록병정、수술전후혈홍단백、자궁내막후도、수술정황화술후수방증상개선정황。결과：①환자년령28～54세，평균（43.5±5.5）세，유엄중내과합병증자점27.1%（19/70），자궁장도（9.17±1.12）cm，낙서주궤공작시간55～179 s，평균（122.00±19.73）s，술시출혈균소우10 mL；소유환자균미발생병발증。②수방폐경솔54.3%（38/70），유효솔97.1%（68/70），재차수술솔2.9%（2/70），궁강적액솔28.6%（20/70）。③술전여술후3개월혈홍단백（98.56 g/L vs.115.27 g/L）급자궁내막후도（9.2 mm vs.3.4 mm）차이유통계학의의（균P=0.000）。④자궁선기병여비자궁선기병환자낙서치료후폐경솔차이유통계학의의（χ2=6.860，P=0.013）。결론：낙서자궁내막거제술치료이상자궁출혈안전、유효、료효현저；자궁선기병가능시영향료효적인소。
Objective:A 3-year follow-up evaluation of the safety, efficacy and outcome analysis of the second generation of endometrial ablation using the NovaSure system. Methods:A study of 70 women with menorrhagia secondary to abnormal uterine bleeding (AUB) who underwent endometrial ablation using the NovaSure system at hysteroscopic center, Fuxing Hospital, Capital Medical University, from January 2011 to December 2013. General condition of these patients, treatment time, complications, hemoglobin and endometrial thickness before and after the operation and rate of surgical re-interventions were recorded. Results: ①Patient:The patient age in this cohort ranged from 28-54 years with a median age of (43.5±5.5) years. 27.1%(19/70) had serious medical complications. The mean sounding length was (9.17±1.12) cm. The time of energy delivery was (122.00±19.73) s, range from 55-179 s. All patients reported small amount of bleeding, less than 10 mL. No complications occurred.②At 3-year follow-up, 97.1%(68/70) experienced a successful reduction in bleeding, 54.3%(38/70) of patients reported amenorrhea. Two of 70 had additional surgery during the follow-up period. 28.6%(20/70) of patients reported fluid accumulation in the uterine cavity.③Hemoglobin and endometrial thickness before and after the operation has a very significant difference (P=0.000), 98.56 g/L vs. 115.27 g/L, 9.2 mm vs. 3.4 mm, respectively. ④Menorrhagia with and without adenomyosis group, amenorhea rate has a very significant difference (χ2=6.860,P=0.013). Conclusions:Clinical result indicate that the NovaSure system is safe and effective method for treatment of women with menorrhagia. Adenomyosis may be one of factors influencing curative effects.
