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2.45吉赫兹频率微波子宫内膜切除术治疗月经过多:单机构治疗结果分析

Microwave endometrial ablation at a frequency of 2.45 GHz for menorrhagia: analysis of treatment results at a single facility.

作者信息

Nakayama Kentaro, Ishibashi Tomoka, Ishikawa Masako, Katagiri Atsuko, Katagiri Hiroshi, Iida Kouji, Nakayama Naomi, Miyazaki Kohji

机构信息

Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo, Japan.

出版信息

J Obstet Gynaecol Res. 2014 Jan;40(1):224-9. doi: 10.1111/jog.12163. Epub 2013 Sep 19.

Abstract

AIM

We aimed to evaluate the efficacy of microwave endometrial ablation at a frequency of 2.45 GHz in women with menorrhagia. This method has been attracting attention as an alternative to hysterectomy in the treatment of functional and organic menorrhagia.

MATERIAL AND METHODS

We performed microwave endometrial ablation in 103 women with menorrhagia between August 2007 and October 2012. All patients had completed child bearing. We evaluated the efficacy of microwave endometrial ablation using a visual analog scale for menorrhagia, dysmenorrhea, and patient satisfaction. We also evaluated the incidence of hypermenorrhea recurrence, amenorrhea, and procedure complications in relation to patients' clinical factors, such as the presence of myoma, adenomyosis, uterine size, and type of bleeding.

RESULTS

A total of 76 patients completed the evaluation period. Excessive menstruation improved from a preoperative mean visual analog score of 10, to 1.9 after treatment. Dysmenorrhea improved from a mean score of 4.2, to 1.3, and patient satisfaction had a mean score of 9.0. Hemoglobin levels improved from 10.1 g/dL preoperatively to 12.5 g/dL postoperatively. Four patients experienced recurrence of excessive menstruation. No related clinical factors could be identified for recurrence risk or the occurrence of postoperative infection. A total of 26 patients (34.2%) became amenorrheic; these patients were less likely to have myomata, intramural myomata, and myomata larger than 5 cm.

CONCLUSIONS

Microwave endometrial ablation at a frequency of 2.45 GHz is an effective and safe treatment. It should be considered as a standard treatment for conservative therapy-resistant menorrhagia.

摘要

目的

我们旨在评估2.45GHz频率的微波子宫内膜切除术对月经过多女性的疗效。作为子宫切除术治疗功能性和器质性月经过多的替代方法,该方法一直备受关注。

材料与方法

2007年8月至2012年10月期间,我们对103例月经过多的女性进行了微波子宫内膜切除术。所有患者均已完成生育。我们使用视觉模拟量表评估微波子宫内膜切除术在月经过多、痛经和患者满意度方面的疗效。我们还评估了月经过多复发、闭经以及手术并发症的发生率与患者临床因素的关系,如肌瘤、子宫腺肌病、子宫大小和出血类型。

结果

共有76例患者完成了评估期。月经过多从术前平均视觉模拟评分为10分改善至治疗后的1.9分。痛经从平均4.2分改善至1.3分,患者满意度平均评分为9.0分。血红蛋白水平从术前的10.1g/dL提高到术后的12.5g/dL。4例患者出现月经过多复发。未发现与复发风险或术后感染发生相关的临床因素。共有26例患者(34.2%)闭经;这些患者肌瘤、肌壁间肌瘤和直径大于5cm肌瘤的发生率较低。

结论

2.45GHz频率的微波子宫内膜切除术是一种有效且安全的治疗方法。对于保守治疗无效的月经过多,应将其视为标准治疗方法。

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