Thermachoice子宫内膜球囊消融术：子宫切除术的一种可能替代方案。

Elgarib A E H, Nooh A

Department of Obstetrics and Gynaecology, Caerphilly Miners' District Hospital, Caerphilly, South Wales, UK.

J Obstet Gynaecol. 2006 Oct;26(7):669-72. doi: 10.1080/01443610600913882.

The purpose of the present audit was to assess the effectiveness and safety of thermal balloon ablation of the endometrium for the treatment of menorrhagia and also to assess patients' satisfaction following the treatment. A total of 50 women successfully underwent endometrial ablation using the Thermachoice balloon system for the treatment of menorrhagia at Caerphilly Miners' District Hospital, Caerphilly, South Wales, UK in the period between September 2000 and December 2002. All cases were performed under a general anaesthetic. There was no equipment failure in this study. No major intra-operative or postoperative complications were noted. However, a post-procedure complication rate of 4% was reported. All cases were discharged within 24 h. Cases were reviewed 3, 6, 12 and 24 months postoperatively. All 50 women attended for follow-up after 3 months. However, two cases were lost for follow-up at 6 months. The number increased to three cases after 12 months and seven cases after 24 months. At each visit, women were interviewed with emphasis on their menstrual history after treatment and the need for further therapy - if any. Women were asked to respond on a four-point ordinal scale to assess satisfaction with treatment (very satisfied, satisfied, dissatisfied or very dissatisfied). Symptomatic improvement was checked by asking participating women to grade the heaviness of their menstrual blood loss as none (amenorrhoea), lighter than before (hypomenorrhoea), or same as before (persistent menorrhagia). Improvement was defined as amenorrhoea or hypomenorrhoea, while procedure failure was defined as persistent menorrhagia. A statistically significant (p = 0.0001) difference was found between pre- and post-treatment heaviness and duration of menstrual flow, as well as the incidence of anaemia. The success rate was maintained over the follow-up period with a range of 86 - 92%. Patient satisfaction was also high at 86%. However, in view of persistent menorrhagia, six patients out of 43 (14%) required further treatment.

本次审计的目的是评估热球囊子宫内膜消融术治疗月经过多的有效性和安全性，并评估患者治疗后的满意度。2000年9月至2002年12月期间，英国南威尔士卡菲利矿工区医院共有50名女性成功接受了使用Thermachoice球囊系统进行的子宫内膜消融术，以治疗月经过多。所有病例均在全身麻醉下进行。本研究中未出现设备故障。未观察到重大的术中或术后并发症。然而，报告的术后并发症发生率为4%。所有病例均在24小时内出院。术后3、6、12和24个月对病例进行复查。所有50名女性在3个月后均前来进行随访。然而，6个月时有2例失访。12个月后失访人数增至3例，24个月后增至7例。每次随访时，都会对女性进行访谈，重点了解她们治疗后的月经史以及是否需要进一步治疗（如有）。要求女性以四点有序量表来评估对治疗的满意度（非常满意、满意、不满意或非常不满意）。通过询问参与研究的女性将月经失血量分为无（闭经）、比以前轻（月经过少）或与以前相同（持续月经过多）来检查症状改善情况。改善定义为闭经或月经过少，而手术失败定义为持续月经过多。治疗前后的经量和经期长度以及贫血发生率之间存在统计学显著差异（p = 0.0001）。随访期间成功率保持在86% - 92%。患者满意度也很高，为86%。然而，鉴于持续月经过多，43名患者中有6名（14%）需要进一步治疗。