Fürst Stine Nymann, Philipsen Torben, Joergensen Joergen Christian
The Department of Obstetrics and Gynaecology, Holbaek County Hospital, Smedelundsgade 60, Holbaek, DK-4300. Denmark.
Acta Obstet Gynecol Scand. 2007;86(3):334-8. doi: 10.1080/00016340601089701.
This paper presents a ten-year follow-up of a randomized, controlled trial which gives the long-term hysterectomy rate and patient satisfaction rate of transcervical hysteroscopic endometrial ablation in the treatment of heavy dysfunctional bleeding.
There were 120 women enrolled in the study, from June 10, 1993 to August 31, 1995, all requiring endometrial ablation for the treatment of heavy dysfunctional bleeding. All patients were offered a clinical examination two years postoperatively. Long-term outcome was assessed by completion of a questionnaire five and ten years after initial treatment. Any new symptomatology and need for further treatment or a hysterectomy was registered. A bleeding index and the patients' satisfaction rate and acceptability of the treatment method were stated.
Sixty-one patients were treated by endometrial coagulation, and 59 by endometrial resection. No significant difference in the number of hysterectomies or satisfaction rate between the two groups was observed. At a ten-year follow-up, 63% of patients only had one ablation, 11% were treated twice, and 22% had a hysterectomy. Only 3% were lost to follow-up. For the group of patients above 40 years of age, only 17% had a hysterectomy. Since the two-year follow-up only six patients with one hysteroscopic treatment have had further intervention. Ninety-four percent of the women would recommend the treatment to their best female friend.
The long-term results show that an ablation for heavy dysfunctional bleeding is an excellent treatment. Overall 22% of patients had a hysterectomy. If the patient had no further intervention at the two-year clinical control, there was only a 6% risk of hysterectomy after a period of at least ten years.
本文介绍了一项随机对照试验的十年随访情况，该试验给出了经宫颈宫腔镜子宫内膜切除术治疗严重功能失调性子宫出血的长期子宫切除率和患者满意率。
1993年6月10日至1995年8月31日期间，有120名妇女参与该研究，她们均因严重功能失调性子宫出血需要进行子宫内膜切除术。所有患者在术后两年接受临床检查。通过在初始治疗后五年和十年完成问卷调查来评估长期结果。记录任何新出现的症状以及进一步治疗或子宫切除的需求。给出了出血指数以及患者对治疗方法的满意率和可接受率。
61例患者接受了子宫内膜凝固术治疗，59例接受了子宫内膜切除术治疗。两组之间的子宫切除数量或满意率没有显著差异。在十年随访时，63%的患者仅接受了一次消融治疗，11%的患者接受了两次治疗，22%的患者接受了子宫切除术。只有3%的患者失访。对于40岁以上的患者组，只有17%的患者接受了子宫切除术。自两年随访以来，仅有6例接受过一次宫腔镜治疗的患者进行了进一步干预。94%的女性会向她们最好的女性朋友推荐这种治疗方法。
长期结果表明，对于严重功能失调性子宫出血，消融术是一种很好的治疗方法。总体而言，22%的患者接受了子宫切除术。如果患者在两年临床检查时没有进一步干预，那么在至少十年后进行子宫切除的风险仅为6%。
