海军医学杂志
海軍醫學雜誌
해군의학잡지
JOURNAL OF NAVY MEDICINE
2015年
3期
224-226,232
,共4页
射频消融%月经失调%子宫内膜%米非司酮%不良反应
射頻消融%月經失調%子宮內膜%米非司酮%不良反應
사빈소융%월경실조%자궁내막%미비사동%불량반응
Radio frequency ablation%Menoxenia%Endometrium%Mifepristone%Adverse reactions
目的:探讨射频消融术治疗功能失调性子宫出血( DUB)的疗效和不良反应。方法将2017例经诊断性刮宫后病理确诊为DUB的患者按治疗方法分成3组。射频治疗组(射频组,1937例)用功率30~35 W消融治疗;米非司酮治疗组(米非司酮组,40例)给予连续口服小剂量米非司酮和输液及止血;常规治疗组(常规组,40例)给予输液止血等治疗,必要时给予高效孕激素。定期检测3组患者血红蛋白、子宫大小、卵巢性激素水平,随访观察疗效及不良反应。结果射频组和米非司酮组治疗后对月经改善、纠正贫血均有效,且2组差异无统计学意义( P>0.05)。米非司酮组治疗后血清卵泡刺激素( FSH)、黄体生成素( LH)、雌二醇( E2)和孕酮( P)的平均水平较治疗前均有不同程度的下降;尤以E2、P下降更为明显,与治疗前比较差异有统计学意义(P<0.01)。射频组治疗前后血清FSH、LH、E2、P平均水平差异无统计学意义(P>0.05)。射频组主要不良反应为人工流产综合征212例,阴道排液115例,低热83例(<38℃)。米非司酮组主要不良反应是:4例患者在停药3个月内出现不规则阴道流血,呈点滴状,2例月经量无明显变化;6个月后12例病情反复,治疗失败,改用其他治疗方法。结论射频组能克服米非司酮治疗的不足,是治疗DUB的一种更为简便、安全、有效、微创的方法。
目的:探討射頻消融術治療功能失調性子宮齣血( DUB)的療效和不良反應。方法將2017例經診斷性颳宮後病理確診為DUB的患者按治療方法分成3組。射頻治療組(射頻組,1937例)用功率30~35 W消融治療;米非司酮治療組(米非司酮組,40例)給予連續口服小劑量米非司酮和輸液及止血;常規治療組(常規組,40例)給予輸液止血等治療,必要時給予高效孕激素。定期檢測3組患者血紅蛋白、子宮大小、卵巢性激素水平,隨訪觀察療效及不良反應。結果射頻組和米非司酮組治療後對月經改善、糾正貧血均有效,且2組差異無統計學意義( P>0.05)。米非司酮組治療後血清卵泡刺激素( FSH)、黃體生成素( LH)、雌二醇( E2)和孕酮( P)的平均水平較治療前均有不同程度的下降;尤以E2、P下降更為明顯,與治療前比較差異有統計學意義(P<0.01)。射頻組治療前後血清FSH、LH、E2、P平均水平差異無統計學意義(P>0.05)。射頻組主要不良反應為人工流產綜閤徵212例,陰道排液115例,低熱83例(<38℃)。米非司酮組主要不良反應是:4例患者在停藥3箇月內齣現不規則陰道流血,呈點滴狀,2例月經量無明顯變化;6箇月後12例病情反複,治療失敗,改用其他治療方法。結論射頻組能剋服米非司酮治療的不足,是治療DUB的一種更為簡便、安全、有效、微創的方法。
목적:탐토사빈소융술치료공능실조성자궁출혈( DUB)적료효화불량반응。방법장2017례경진단성괄궁후병리학진위DUB적환자안치료방법분성3조。사빈치료조(사빈조,1937례)용공솔30~35 W소융치료;미비사동치료조(미비사동조,40례)급여련속구복소제량미비사동화수액급지혈;상규치료조(상규조,40례)급여수액지혈등치료,필요시급여고효잉격소。정기검측3조환자혈홍단백、자궁대소、란소성격소수평,수방관찰료효급불량반응。결과사빈조화미비사동조치료후대월경개선、규정빈혈균유효,차2조차이무통계학의의( P>0.05)。미비사동조치료후혈청란포자격소( FSH)、황체생성소( LH)、자이순( E2)화잉동( P)적평균수평교치료전균유불동정도적하강;우이E2、P하강경위명현,여치료전비교차이유통계학의의(P<0.01)。사빈조치료전후혈청FSH、LH、E2、P평균수평차이무통계학의의(P>0.05)。사빈조주요불량반응위인공유산종합정212례,음도배액115례,저열83례(<38℃)。미비사동조주요불량반응시:4례환자재정약3개월내출현불규칙음도류혈,정점적상,2례월경량무명현변화;6개월후12례병정반복,치료실패,개용기타치료방법。결론사빈조능극복미비사동치료적불족,시치료DUB적일충경위간편、안전、유효、미창적방법。
Objective To investigate therapeutic effects of radio frequency ablation ( RFCA) on dysfunctional uterine bleed-ing ( DUB) and analysis of its adverse reactions.Methods In accordance with different methods of treatment, 2 017 cases of dysfunc-tional uterine bleeding patients confirmed and diagnosed by dilatation and curettage were randomly divided into 3 groups: the RFCA group, the mifepristone group and the control group.The RFCA group (1 937 cases) received radio frequency ablation at a power rate of 30-35 W, the mifepristone group (40 cases) was continually given small doses of mifepristone orally, intravenous infusion and he-mostasis, and the control group (40 cases) received intravenous infusion, hemostasis and highly effective progestogen, as deemed nec-essary.The levels of hemoglobin ( Hgb) , the sizes of wombs and the levels of ovary hormone in the patients of the 3 groups were detec-ted periodically, and they all had medical follow-ups for observation of adverse reactions.Results After treatment, improvement could be seen in menorrhagia and anemia for the RFCA group and mifepristone group, but without statistical differences (P>0.05).In the mifepristone group, the mean levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17-esradiol (E2), progester-one ( P) were decreased in varying degrees following treatment, with Ez and P decreased more prominently, as compared with those be-fore medication (P<0.01), while the mean levels of FSH, LH, E2 and P did not fluctuate markedly for the RFCA group, and no sta-tistical significance could be seen, when comparisons were made between pre-treatment and post-treatment (P>0.05) .Main adverse reactions after treatment in the RFCA group were artificial abortion syndromes (212 cases), vaginal discharge (115 cases) and low fe-ver (83 cases)(<38℃).Main adverse reactions in the mifepristone group 3 months after drug withdrawal were irregular colporrhagia (4 cases) and insignificant changes in menstrual flow (2 cases).After 6 months, there was recurrence in 12 cases, which failed to re-spond to the original treatment, and as a result, other treatment had to be used instead.Conclusion The RFCA group could overcome <br> the deficiency of mifepristone and was a simpler, safer, more effective and less invasive treatment method.