Bouzari Zinatossadat, Alijanpour Ebrahim, Yazdani Shahla, Ghanbarpour Azita, Bijani Ali, Ashraf Ganjoei Tahereh, Gholinia Hemmat
Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
The Clinical Research Development Unite of Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.
Caspian J Intern Med. 2021 Apr;12(3):336-341. doi: 10.22088/cjim.12.3.336.
The purpose of the study was to evaluate the effectiveness and safety of thermal balloon ablation in women with high anesthetic and surgical risk compared to invulnerable women according to the American Society of Anesthesia (ASA) physical status stratification.
This report was based on a retrospective cohort study of women with heavy menstrual bleeding (HMB) who were eligible for treatment with Cavaterm plus during 2012-2017. Women were classified as high-risk (HR) or low-risk (LR) cohorts based on ASA physical status stratification. The primary outcome includes amenorrhea in the twelfth months after the treatment. Risk adjustments were performed using regression models.
This research study consisted of 63 women with mean age 44.42±5.48. Mean of body mass index (BMI) in the HR cohort was higher than the LR cohort (31.48±6.22 vs 26.83± 3.51, P=0.005) and results were also similar considering the uterine length (mm) between HR and LR women (58.27±35.70 vs 30.92± 35.30, P=0.01). The primary outcome of treatment after a one-year follow-up in the two groups (HR and LR) was 31 (93.9%) and 15 (78.9%), respectively. After adjusting for known confounders including age, uterine length, parity, dysmenorrheal, the adjusted odds ratio was 0.94 (95% CI, 0.14- 2.5; P= 0.60).
For women with high anesthetic and surgical risks derived from serious underlying co morbidities, endometrial ablation can provide a minimally invasive, safe, and effective therapy for heavy menstrual bleeding.
本研究的目的是根据美国麻醉医师协会（ASA）身体状况分层，评估与身体状况良好的女性相比，麻醉和手术风险高的女性进行热球囊消融术的有效性和安全性。
本报告基于一项对2012年至2017年期间符合Cavaterm plus治疗条件的月经过多（HMB）女性的回顾性队列研究。根据ASA身体状况分层，将女性分为高风险（HR）或低风险（LR）队列。主要结局包括治疗后第12个月的闭经情况。使用回归模型进行风险调整。
本研究包括63名平均年龄为44.42±5.48岁的女性。HR队列的平均体重指数（BMI）高于LR队列（31.48±6.22 vs 26.83±3.51，P = 0.005），并且考虑HR和LR女性之间的子宫长度（mm）时结果也相似（58.27±35.70 vs 30.92±35.30，P = 0.01）。两组（HR和LR）在一年随访后的治疗主要结局分别为31例（93.9%）和15例（78.9%）。在调整包括年龄、子宫长度、产次、痛经等已知混杂因素后，调整后的优势比为0.94（95%CI，0.14 - 2.5；P = 0.60）。
对于因严重基础合并症而具有高麻醉和手术风险的女性，子宫内膜消融可为月经过多提供微创、安全且有效的治疗方法。
