剖宫产术后全球子宫内膜消融术的疗效和安全性：一项队列研究。
Efficacy and safety of global endometrial ablation after cesarean delivery: a cohort study.
机构信息
Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA.
出版信息
Am J Obstet Gynecol. 2011 Nov;205(5):450.e1-4. doi: 10.1016/j.ajog.2011.06.106. Epub 2011 Jul 13.
OBJECTIVE
The objective of the study was to evaluate the efficacy and safety of global endometrial ablation in women with a history of cesarean delivery.
STUDY DESIGN
We performed a historical cohort study of patients who underwent endometrial ablation for menorrhagia between 1998 and 2005. Outcome measures included amenorrhea, treatment failure, and operative complications. Time to treatment failure was compared using Kaplan-Meier analysis. Risk adjustments were performed using Cox and logistic regression models.
RESULTS
Of 704 patients meeting inclusion criteria, 162 (23%) had a history of 1 or more cesarean deliveries. Women with and without a history of cesarean delivery had comparable rates for 5 year cumulative endometrial ablation failure, amenorrhea, treatment failure, and operative complications. The type of ablation device and number of previous cesarean deliveries did not affect any outcomes.
CONCLUSION
The efficacy and safety of endometrial ablation are comparable in women with or without a history of cesarean delivery.
目的
本研究旨在评估剖宫产史妇女行子宫内膜消融术的疗效和安全性。
研究设计
我们对 1998 年至 2005 年间因月经过多而行子宫内膜消融术的患者进行了历史性队列研究。结局指标包括闭经、治疗失败和手术并发症。采用 Kaplan-Meier 分析比较治疗失败时间。采用 Cox 和逻辑回归模型进行风险调整。
结果
符合纳入标准的 704 例患者中，162 例（23%）有 1 次或多次剖宫产史。有剖宫产史和无剖宫产史的患者 5 年累积子宫内膜消融失败、闭经、治疗失败和手术并发症的发生率相当。消融装置的类型和剖宫产次数均不影响任何结局。
结论
有剖宫产史和无剖宫产史的妇女行子宫内膜消融术的疗效和安全性相当。
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