CAJ | 학술논문

目的：探讨诺舒（ NovaSure ）阻抗控制子宫内膜切除系统治疗心脏病术后异常子宫出血（ abnormal uterine bleeding，AUB）的临床疗效。方法2011年6月～2013年1月采用诺舒对15例心脏病术后AUB行子宫内膜去除术，术前排除子宫内膜及宫颈恶性病变，扩张宫颈后先行宫腔镜检查，然后将诺舒阻抗控制子宫内膜切除系统的双极消融器送入宫腔，测试通过后行子宫内膜去除，再次宫腔镜检查，了解子宫内膜去除情况。记录术前后情况，并进行1、3、6个月随访，观察月经情况和并发症。结果15例术中生命体征平稳，手术顺利。血红蛋白术前（91．33±21．38） g／L，术后6个月升高至（113．89±19．32）g／L，有统计学差异（t＝5．640，P＝0．000），贫血状态明显好转。1例心功能由Ⅲ级变为Ⅱ级，2例心功能由Ⅱ级变为Ⅰ级，其余患者心功能未见变化。术后1、3、6个月随访15例，治疗均有效（参照月经改善评价标准），闭经率分别为66．7％（10／15）、73．3％（11／15）、80．0％（12／15）。结论诺舒阻抗子宫内膜切除术治疗心脏病术后AUB疗效确切，安全性高。
목적：탐토낙서（ NovaSure ）조항공제자궁내막절제계통치료심장병술후이상자궁출혈（ abnormal uterine bleeding，AUB）적림상료효。방법2011년6월～2013년1월채용낙서대15례심장병술후AUB행자궁내막거제술，술전배제자궁내막급궁경악성병변，확장궁경후선행궁강경검사，연후장낙서조항공제자궁내막절제계통적쌍겁소융기송입궁강，측시통과후행자궁내막거제，재차궁강경검사，료해자궁내막거제정황。기록술전후정황，병진행1、3、6개월수방，관찰월경정황화병발증。결과15례술중생명체정평은，수술순리。혈홍단백술전（91．33±21．38） g／L，술후6개월승고지（113．89±19．32）g／L，유통계학차이（t＝5．640，P＝0．000），빈혈상태명현호전。1례심공능유Ⅲ급변위Ⅱ급，2례심공능유Ⅱ급변위Ⅰ급，기여환자심공능미견변화。술후1、3、6개월수방15례，치료균유효（삼조월경개선평개표준），폐경솔분별위66．7％（10／15）、73．3％（11／15）、80．0％（12／15）。결론낙서조항자궁내막절제술치료심장병술후AUB료효학절，안전성고。
Objective To investigate the efficacy of NovaSure system in the treatment of abnormal uterine bleeding ( AUB) after cardiac surgery. Methods From June 2011 to January 2013, 15 patients with AUB after cardiac surgery receiving NovaSure system treatment were studied retrospectively.Before the operation, patients with endometrial and cervical malignant lesions were ruled out.After hysteroscopic examination, the patients received endometrial ablation with the NovaSure system.Then a re-exmanination of hysteroscopy was performed to confirm the surgical outcomes.The menstrual conditions and complications were followed up at 1, 3, and 6 months postoperatively. Results All the procedures were completed successfully.The mean hemoglobin was ( 91.33 ± 21.38) g/L preoperation and (113.89 ±19.32) g/L 6 months after operation.The difference was statistically significant (t=5.640, P=0.000).The cardiac functions were changed from NYHAⅢto NYHAⅡin 1 case and from NYHAⅡto NHYHⅠin 2 cases. Fifteen patients were followed up at 1, 3, and 6 months postoperatively, which showed amenorrhea rates were 66.7%(10/15),73.3%(11/15),and 80.0%(12/15),respectively.According to the evaluation standard of menstrual improvement,the therapeutic results were effective. Conclusion The NovaSure system shows good efficacy and safety in the treatment of AUB after cardiac surgery.