Loffer Franklin D
Department of Obstetrics and Gynecology, University of Arizona, Phoenix, Arizona 85013, USA.
J Minim Invasive Gynecol. 2005 May-Jun;12(3):254-60. doi: 10.1016/j.jmig.2005.04.001.
To evaluate the effect of endometrial ablation on the outcome of premenopausal patients undergoing hysteroscopic myomectomy for menorrhagia or menometrorrhagia
Retrospective cohort study (Canadian Task Force classification II-2).
Private practice.
One hundred seventy-seven women with one or more submucosal myomas experiencing menorrhagia or menometrorrhagia.
Hysteroscopic myomectomy without endometrial ablation in 104 patients and with concomitant endometrial ablation in 73 patients.
Bleeding was controlled in 95.9% of patients with endometrial ablation and in 80.8% of patients without endometrial ablation (p = .003). Complete removal of the myoma led to better results (p = .039), which were further improved by endometrial ablation (p = .022). Endometrial ablation improved bleeding in patients whose myomas could not be completely removed, but the difference was not statistically significant (p = .23). Subsequent hysterectomies were not decreased by endometrial ablation (p = .48) or by complete removal of the myoma (p = .83). Hysterectomies for bleeding problems were decreased by endometrial ablation. Pain and dysmenorrhea were a frequent cause of hysterectomy.
Endometrial ablation at the time of hysteroscopic myomectomy improves results in the control of bleeding.
评估子宫内膜切除术对因月经过多或功能性子宫出血而接受宫腔镜子宫肌瘤切除术的绝经前患者治疗结果的影响。
回顾性队列研究（加拿大工作组分类II - 2）。
私人诊所。
177名患有一个或多个黏膜下肌瘤且有月经过多或功能性子宫出血症状的女性。
104例患者接受了无子宫内膜切除术的宫腔镜子宫肌瘤切除术，73例患者同时接受了子宫内膜切除术。
接受子宫内膜切除术的患者中95.9%的出血得到控制，未接受子宫内膜切除术的患者中这一比例为80.8%（p = 0.003）。肌瘤完全切除取得了更好的效果（p = 0.039），子宫内膜切除术进一步改善了效果（p = 0.022）。子宫内膜切除术改善了肌瘤无法完全切除患者的出血情况，但差异无统计学意义（p = 0.23）。子宫内膜切除术（p = 0.48）或肌瘤完全切除（p = 0.83）均未减少后续子宫切除术的发生率。因出血问题进行的子宫切除术因子宫内膜切除术而减少。疼痛和痛经是子宫切除术的常见原因。
宫腔镜子宫肌瘤切除术时进行子宫内膜切除术可改善出血控制效果。
