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一项关于NovaSure系统治疗月经过多安全性和有效性的随机多中心试验。

A randomized, multicenter trial of safety and efficacy of the NovaSure system in the treatment of menorrhagia.

作者信息

Cooper Jay, Gimpelson Richard, Laberge Philippe, Galen Donald, Garza-Leal Jose Gerardo, Scott Josef, Leyland Nicholas, Martyn Paul, Liu James

机构信息

Ob/Gyn Consultants, 6036 North 19th Avenue, Suite 401, Phoenix, AZ 85015, USA.

出版信息

J Am Assoc Gynecol Laparosc. 2002 Nov;9(4):418-28. doi: 10.1016/s1074-3804(05)60513-0.

Abstract

STUDY OBJECTIVE

To compare the safety and effectiveness of the NovaSure impedance-controlled endometrial ablation system with hysteroscopic wire loop resection plus rollerball ablation for treatment of excessive uterine bleeding in premenopausal women.

DESIGN

Randomized, multicenter, double-arm study (Canadian Task Force classification I).

SETTING

Nine academic medical centers and private offices.

PATIENTS

Two hundred sixty-five premenopausal women with symptomatic menorrhagia.

INTERVENTION

Ablation performed with the NovaSure system or wire loop resection and rollerball.

MEASUREMENTS AND MAIN RESULTS

Success [pictorial blood loss-assessment chart (PBLAC) score < or =75] was achieved in 88.3% of NovaSure-treated and 81.7% of rollerball-treated patients. One year after treatment 90.9% and 87.8%, respectively, reported normal bleeding or less (PBLAC < or =100) and 41% and 35%, respectively, experienced amenorrhea (PBLAC = 0). Mean procedure time was 4.2 minutes (average 84 sec) in the NovaSure group and 24.2 minutes in the rollerball group. Local and/or intravenous sedation was administered in 73% of NovaSure patients and 18% of rollerball patients. Intraoperative adverse events occurred less frequently with NovaSure (0.6%) than with rollerball (6.7%). Postoperative adverse events occurred in 13% and 25.3% of patients, respectively.

CONCLUSION

The NovaSure system was safe and effective in treatment of women with menorrhagia. The procedure is both quick and effective, and eliminates the expense and side effects of endometrial pretreatment.

摘要

研究目的

比较NovaSure阻抗控制子宫内膜切除术系统与宫腔镜金属丝环切除术加滚球消融术治疗绝经前妇女子宫出血过多的安全性和有效性。

设计

随机、多中心、双臂研究(加拿大工作组分类I)。

地点

9个学术医疗中心和私人诊所。

患者

265名有症状性月经过多的绝经前妇女。

干预措施

采用NovaSure系统或金属丝环切除术及滚球消融术进行消融。

测量指标及主要结果

NovaSure治疗组88.3%的患者和滚球治疗组81.7%的患者获得成功[图像失血评估图(PBLAC)评分≤75]。治疗一年后,分别有90.9%和87.8%的患者报告出血正常或减少(PBLAC≤100),分别有41%和35%的患者出现闭经(PBLAC = 0)。NovaSure组的平均手术时间为4.2分钟(平均84秒),滚球组为24.2分钟。73%的NovaSure患者和18%的滚球患者接受了局部和/或静脉镇静。NovaSure术中不良事件发生率(0.6%)低于滚球组(6.7%)。术后不良事件分别发生在13%和25.3%的患者中。

结论

NovaSure系统治疗月经过多的女性安全有效。该手术快速有效,消除了子宫内膜预处理的费用和副作用。

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