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子宫内膜激光宫内热疗:对首批100例患者进行为期1年的观察。

Endometrial laser intrauterine thermotherapy: the first series of 100 patients observed for 1 year.

作者信息

Donnez J, Polet R, Rabinovitz R, Ak M, Squifflet J, Nisolle M

机构信息

Department of Gynecology, Cliniques Universitaires St. Luc, Université Catholique de Louvain, Brussels, Belgium.

出版信息

Fertil Steril. 2000 Oct;74(4):791-6. doi: 10.1016/s0015-0282(00)00715-9.

Abstract

OBJECTIVE

To describe a new instrument (GyneLase) that offers a new approach (endometrial laser intrauterine thermal therapy [ELITT]) to treatment of menorrhagia and to evaluate the efficacy of ELITT in the management of dysfunctional uterine bleeding.

DESIGN

Prospective study.

SETTING

University hospital.

PATIENT(S): 100 premenopausal women with dysfunctional uterine bleeding were observed for 1 year.

INTERVENTION(S): Intrauterine laser thermotherapy with a diode laser.

MAIN OUTCOME MEASUREMENT(S): Amenorrhea rate after 1 year.

RESULT(S): The amenorrhea rate after 1 year of follow-up was 71%, and the rate of amenorrhea/severe hypomenorrhea rate was >90%; these rates are much higher than those in the literature after such procedures as electrosurgery or intrauterine thermal balloon therapy. The ELITT procedure is an inherently safe and simple alternative, providing controlled and effective treatment of the entire endometrium. In contrast to traditional endometrial ablation using a neodymium yttrium-aluminum-garnet laser, the ELITT procedure does not require intensive training or hysteroscopic control; it is also far less risky, because the power used per unit area is 1,000 times lower.

CONCLUSION(S): The ELITT procedure is a new nonhysteroscopic technique for endometrial ablation. The technique is very safe and offers the highest amenorrhea rate to date in the literature.

摘要

目的

描述一种新仪器(GyneLase),它为治疗月经过多提供了一种新方法(子宫内膜激光宫内热疗[ELITT]),并评估ELITT在治疗功能失调性子宫出血中的疗效。

设计

前瞻性研究。

地点

大学医院。

患者

100名功能失调性子宫出血的绝经前女性被观察1年。

干预措施

使用二极管激光进行宫内激光热疗。

主要观察指标

1年后的闭经率。

结果

随访1年后的闭经率为71%,闭经/严重月经过少率>90%;这些比率远高于电外科手术或宫内热球囊治疗等手术后文献报道的比率。ELITT手术本质上是一种安全且简单的替代方法,可对整个子宫内膜进行可控且有效的治疗。与使用钕钇铝石榴石激光进行的传统子宫内膜切除术不同,ELITT手术不需要强化培训或宫腔镜控制;风险也低得多,因为单位面积使用的功率低1000倍。

结论

ELITT手术是一种新的非宫腔镜子宫内膜切除术技术。该技术非常安全,且在文献中提供了迄今为止最高的闭经率。

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