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微波子宫内膜切除术治疗月经过多:2年随访结果——一家区综合医院的经验

Microwave endometrial ablation for menorrhagia: outcome at 2 years--experience of a district general hospital.

作者信息

Sharma B, Preston J, Ray C

机构信息

Department of Obstetrics and Gynaecology, James Paget Hospital, Great Yarmouth, UK.

出版信息

J Obstet Gynaecol. 2004 Nov;24(8):916-9. doi: 10.1080/01443610400019005.

Abstract

One hundred and twenty-three women underwent microwave endometrial ablation (MEA) for the treatment of dysfunctional uterine bleeding (DUB). The mean age at treatment was 40.2 years and the average treatment time was 2 minutes 50 seconds. All patients stayed as day cases, except for two who stayed overnight, one due to pain and the other due to urinary retention. The follow-up was carried out at 6 months, 1 and 2 years, respectively. The success rate was 80%, 76% and 70% at 6 months and 1-year and 2-year follow-up. The patient satisfaction rate was 80%, 75% and 68% at 6 months, 1 year and 2 years, respectively. However, in women 45 years old and over the success rate was more than 90%, suggesting that MEA could be a preferred procedure for treatment of DUB in this age group compared to younger women, especially in those who do not benefit from the mirena intrauterine system or decline it. Approximately 70% of patients, who underwent hysterectomy due to the failure of treatment, had uterine/pelvic pathology in the form of adenomyosis, fibroid uterus or endometriosis; therefore prior to MEA, proper patient selection is vital. There were a few minor complications but no uterine perforation or emergency hysterectomies in the group studied.

摘要

123名女性接受了微波子宫内膜切除术(MEA)以治疗功能失调性子宫出血(DUB)。治疗时的平均年龄为40.2岁,平均治疗时间为2分50秒。除两名患者留院过夜外,所有患者均为日间手术,其中一名是因为疼痛,另一名是因为尿潴留。分别在6个月、1年和2年进行随访。6个月、1年和2年随访时的成功率分别为80%、76%和70%。患者满意度在6个月、1年和2年时分别为80%、75%和68%。然而,45岁及以上女性的成功率超过90%,这表明与年轻女性相比,MEA可能是该年龄组治疗DUB的首选方法,特别是对于那些无法从曼月乐宫内节育系统中获益或拒绝使用该系统的女性。因治疗失败而接受子宫切除术的患者中,约70%存在子宫腺肌病、子宫肌瘤或子宫内膜异位症等子宫/盆腔病变;因此,在进行MEA之前,正确选择患者至关重要。在研究组中出现了一些轻微并发症,但没有子宫穿孔或急诊子宫切除术的情况。

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