Department of Obstetrics and Gynaecology, St. Thomas' Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK. rajesh.varma @ gstt.nhs.uk
Gynecol Obstet Invest. 2010;70(3):145-8. doi: 10.1159/000316261. Epub 2010 Jun 16.
To evaluate short- and long-term treatment outcomes of outpatient local anaesthetic thermal balloon endometrial ablation (LA-TBEA) and identify any prognostic factors.
Prospective observational study in a UK teaching hospital involving 102 menorrhagic women undergoing LA-TBEA between 2001 and 2005. Women underwent either Gynecare® Thermachoice I (n = 51) or Thermachoice III (n = 51) TBEA performed in the outpatient setting under local anaesthesia without conscious sedation. The main outcome measures were: treatment completion, pain and analgesia, duration of stay (from admission to discharge), duration of follow-up, primary treatment success and nature of any secondary treatment, menstrual symptoms and amenorrhoea, patient satisfaction, and quality of life.
TBEA was completed in 97% of women. Mean duration of stay was 8.0 h (95% CI 6.6-9.3). Mean follow-up was 30 months (95% CI 26-32). Secondary treatment with the levonorgestrel intrauterine system, repeat TBEA or hysterectomy occurred in 19/102 (19%). Overall, 50% of surgical re-interventions occurred by 19 months. There were high rates of amenorrhoea (29%) and treatment satisfaction (76%). Higher mean intrauterine ablation pressure was associated with increased treatment satisfaction.
TBEA can be successfully performed in the outpatient setting. Higher endometrial ablation pressure may improve long-term treatment outcome.
评估门诊局部麻醉热球子宫内膜消融术（LA-TBEA）的短期和长期治疗效果，并确定任何预后因素。
这是一项在英国教学医院进行的前瞻性观察研究，涉及 2001 年至 2005 年间接受 LA-TBEA 的 102 例月经过多妇女。这些妇女接受了 Gynecare®Thermachoice I（n = 51）或 Thermachoice III（n = 51）TBEA 治疗，均在门诊局部麻醉下进行，无需镇静。主要观察指标为：治疗完成情况、疼痛和镇痛、住院时间（从入院到出院）、随访时间、主要治疗成功率以及任何继发性治疗的性质、月经症状和闭经、患者满意度以及生活质量。
97%的妇女完成了 TBEA。平均住院时间为 8.0 小时（95%可信区间 6.6-9.3）。平均随访时间为 30 个月（95%可信区间 26-32）。19/102（19%）名妇女接受了左炔诺孕酮宫内节育系统、重复 TBEA 或子宫切除术等继发性治疗。总体而言，19 个月内有 50%的手术再次干预。闭经率（29%）和治疗满意度（76%）均较高。较高的宫腔内消融压力与较高的治疗满意度相关。
TBEA 可在门诊环境下成功进行。较高的子宫内膜消融压力可能改善长期治疗效果。
