Chapa Hector O
Women's Specialty Center, 1135 North Bishop Avenue, Dallas, TX 75208, USA.
J Reprod Med. 2008 Nov;53(11):827-31.
To determine tolerability of in-office endometrial ablation under local anesthesia and the rate of adverse events in the first 2 postoperative weeks.
The study was a prospective cohort single group study.
Ablation was performed on 148 patients under deep parametrial block using dilute mepivacaine and oral anxiolysis. No patient requested the procedure be stopped due to pain, but 1 requested intraoperative reinjection of anesthetic. No patient required admission due to pain. No serious adverse events were noted intraoperatively or in the first 2 weeks following the procedure. The most common adverse event at follow-up was bacterial vaginosis in 16 of 143 (11%) of the evaluable cohort. Five patients were seen after the first 2 weeks, without complications, but were therefore excluded from the study. Patient satisfaction was assessed at 2-week follow-up visit in the 143 evaluable cohort. A total of 130 of 143 patients (90%) reported being "Very Satisfied", 13 (9.1%) reported being "Satisfied" and none were "Unsatisfied".
Endometrial ablation can be performed successfully in the physician's office under local anesthesia and oral anxiolysis with low patient pain scores, high tolerability and high patient satisfaction. Serious adverse events were not encountered when performed by properly trained practitioners.
确定门诊局部麻醉下子宫内膜消融术的耐受性以及术后前2周不良事件的发生率。
本研究为前瞻性队列单组研究。
对148例患者采用稀释的甲哌卡因行深部宫旁阻滞及口服抗焦虑药后进行消融术。没有患者因疼痛要求停止手术，但有1例患者术中要求再次注射麻醉药。没有患者因疼痛需要住院。术中及术后前2周均未发现严重不良事件。随访时最常见的不良事件是可评估队列中143例患者中有16例（11%）发生细菌性阴道病。术后2周后有5例患者前来就诊，无并发症，但因此被排除在研究之外。在可评估的143例队列中，在2周随访时评估患者满意度。143例患者中共有130例（90%）报告“非常满意”，13例（9.1%）报告“满意”，无“不满意”者。
在门诊局部麻醉及口服抗焦虑药的情况下，子宫内膜消融术可成功进行，患者疼痛评分低、耐受性高且患者满意度高。由经过适当培训的从业者进行该手术时未遇到严重不良事件。
