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热球囊子宫内膜消融术治疗月经过多

Thermal balloon endometrial ablation in the treatment of heavy menstrual bleeding.

作者信息

Bouzari Zinatossadat, Yazdani Shahla, Azimi Samira, Delavar Mouloud Agajani

机构信息

Fatemezahra Infertility and Reproductive Health Research Center, Department of Obstetrics and Gynecology, Babol University of Medical Sciences, Iran.

Resident of Department of Obstetrics and Gynecology of Babol University of Medical Sciences, Iran.

出版信息

Med Arch. 2014 Dec;68(6):411-3. doi: 10.5455/medarh.2014.68.411-413. Epub 2014 Dec 16.

Abstract

AIM

Heavy menstrual bleeding is one of the common health problems in women. The first-line therapy of heavy menstrual bleeding is the medical therapy, but this is not successful. Currently, global ablation procedures were introduced for treating of heavy menstrual bleeding. The aim of this study was to the analysis of the patient with menorrhagia performed operations of Cavaterm in our university affiliated hospital, and explores its effectiveness and acceptability.

METHODS

A retrospective study was conducted on 30 patients with menorrhagia who were unresponsive to hormone therapy or not candidates for hysterectomy underwent endometrial ablation using Cavaterm. Preoperative and postoperative PBAC Scoring System was used to assess menorrhagia. Outcome measures were amenorrhea rates, reduction of menstrual flow rates, heavy bleeding, menstrual and patients' satisfaction rates at 3, 6 and 12 months postoperative.

RESULTS

After a follow-up at 3, 6, and 12 months postoperative, 36.7%, 43.3%, and 36.7% of women had a reduction in vaginal bleeding, respectively. Amenorrhea rates were 56.7%, 50.0%, and 56.7% in the Cavaterm at 3, 6, and 12 months. The rate of women's reported good or excellent satisfaction was 93.3% in 12 months. During the follow-up period, no woman received a subsequent hysterectomy.

CONCLUSION

The findings of this research indicated that outcome with the Cavaterm was as good for women with menorrhagia. Therefore, it is necessary to emphasize on lower operative and post-operative procedural risk and a deleterious effect on patients who were unresponsive to hormone therapy.

摘要

目的

月经过多是女性常见的健康问题之一。月经过多的一线治疗方法是药物治疗,但并不成功。目前,全球引入了消融手术来治疗月经过多。本研究的目的是分析在我们大学附属医院接受Cavaterm手术的月经过多患者,并探讨其有效性和可接受性。

方法

对30例对激素治疗无反应或不适合子宫切除术的月经过多患者进行回顾性研究,这些患者接受了使用Cavaterm的子宫内膜消融术。术前和术后使用PBAC评分系统评估月经过多情况。观察指标为术后3、6和12个月时的闭经率、月经量减少率、大出血情况、月经情况以及患者满意度。

结果

术后3、6和12个月随访时,分别有36.7%、43.3%和36.7%的女性阴道出血减少。Cavaterm在3、6和12个月时的闭经率分别为56.7%、50.0%和56.7%。12个月时女性报告的良好或优秀满意度为93.3%。在随访期间,没有女性接受后续子宫切除术。

结论

本研究结果表明,Cavaterm对月经过多女性的治疗效果良好。因此,有必要强调该手术较低的手术和术后风险以及对激素治疗无反应患者的有害影响。

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本文引用的文献

1
Endometrial resection and ablation versus hysterectomy for heavy menstrual bleeding.
Cochrane Database Syst Rev. 2013 Nov 29(11):CD000329. doi: 10.1002/14651858.CD000329.pub2.
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Thermal balloon endometrial ablation in dysfunctional uterine bleeding.
J Gynecol Endosc Surg. 2009 Jan;1(1):31-3. doi: 10.4103/0974-1216.51907.
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Endometrial thermal balloon ablation has a beneficial long-term effect on menorrhagia.
Acta Obstet Gynecol Scand. 2008;87(1):107-10. doi: 10.1080/00016340701797823.
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Thermal balloon endometrial ablation: a systematic review.
Arch Gynecol Obstet. 2008 Feb;277(2):99-108. doi: 10.1007/s00404-007-0449-7. Epub 2007 Sep 6.
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Thermal balloon endometrial ablation (Cavaterm) in the management of menorrhagia.
J Obstet Gynaecol. 2006 Nov;26(8):804-5. doi: 10.1080/01443610600984495.
9
Endometrial destruction techniques for heavy menstrual bleeding.
Cochrane Database Syst Rev. 2005 Oct 19(4):CD001501. doi: 10.1002/14651858.CD001501.pub2.

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