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The surgical treatment of idiopathic abnormal uterine bleeding: An analysis of 88 000 patients from the French exhaustive national hospital discharge database from 2009 to 2015.特发性异常子宫出血的外科治疗:2009 年至 2015 年法国详尽国家住院患者数据库中 88000 例患者的分析。
PLoS One. 2019 Jun 11;14(6):e0217579. doi: 10.1371/journal.pone.0217579. eCollection 2019.
2
Radiofrequency endometrial ablation for treating heavy menstrual bleeding in women with chronic renal failure.射频子宫内膜消融术治疗慢性肾衰竭妇女月经过多。
Int J Hyperthermia. 2018;35(1):612-616. doi: 10.1080/02656736.2018.1515445. Epub 2018 Nov 1.
3
Effectiveness of bipolar impedance controlled radiofrequency (NovaSure) endometrial ablation for the treatment of menorrhagia in Hong Kong Chinese women.双极阻抗控制射频(NovaSure)子宫内膜切除术治疗香港华裔女性月经过多的疗效
Gynecol Minim Invasive Ther. 2017 Oct-Dec;6(4):186-190. doi: 10.1016/j.gmit.2017.06.006. Epub 2017 Jul 31.
4
The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions.FIGO 两种正常和异常子宫出血症状系统及其生殖年龄段异常子宫出血病因分类:2018 年修订版。
Int J Gynaecol Obstet. 2018 Dec;143(3):393-408. doi: 10.1002/ijgo.12666. Epub 2018 Oct 10.
5
Classification and the diagnostics of abnormal uterine bleeding in nongravid women of reproductive age: The PALM-COEIN classification system adopted by the International Federation of Gynecology and Obstetrics.育龄非妊娠妇女异常子宫出血的分类与诊断:国际妇产科联盟采用的PALM-COEIN分类系统。
Vojnosanit Pregl. 2016 Dec;73(12):1154-9. doi: 10.2298/VSP160709289S.
6
Intraoperative Predictors of Long-term Outcomes After Radiofrequency Endometrial Ablation.射频子宫内膜消融术后长期结局的术中预测因素
J Minim Invasive Gynecol. 2016 May-Jun;23(4):582-9. doi: 10.1016/j.jmig.2016.02.002. Epub 2016 Feb 9.
7
The medical management of abnormal uterine bleeding in reproductive-aged women.育龄期女性异常子宫出血的药物治疗
Am J Obstet Gynecol. 2016 Jan;214(1):31-44. doi: 10.1016/j.ajog.2015.07.044. Epub 2015 Aug 5.
8
Hysteroscopy and heavy menstrual bleeding (to cover TCRE and second-generation endometrial ablation).宫腔镜检查和月经过多(涵盖 TCRE 和第二代子宫内膜消融术)。
Best Pract Res Clin Obstet Gynaecol. 2015 Oct;29(7):930-9. doi: 10.1016/j.bpobgyn.2015.03.011. Epub 2015 Apr 7.
9
Endometrial resection and ablation versus hysterectomy for heavy menstrual bleeding.子宫内膜切除术和消融术与子宫切除术治疗月经过多的比较
Cochrane Database Syst Rev. 2013 Nov 29(11):CD000329. doi: 10.1002/14651858.CD000329.pub2.
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First- versus second-generation endometrial ablation devices for treatment of menorrhagia: a systematic review, meta-analysis and appraisal of economic evaluations.用于治疗月经过多的第一代与第二代子宫内膜消融设备:系统评价、荟萃分析及经济评估鉴定
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NovaSure 子宫内膜消融术治疗异常子宫出血 2152 例临床分析。

Clinical analysis of 2152 cases of abnormal uterine bleeding treated by NovaSure endometrial ablation.

机构信息

Department of Gynecology and Obstetrics, the Third Xiangya Hospital, Central South University, Changsha, China.

Shenzhen-shanwei Central Hospital, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Shanwei City, Guangdong Province, China.

出版信息

Int J Gynaecol Obstet. 2022 Aug;158(2):301-307. doi: 10.1002/ijgo.13983. Epub 2021 Nov 16.

DOI:10.1002/ijgo.13983
PMID:34653258
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9540028/
Abstract

OBJECTIVE

To evaluate the efficiency, postoperative hysterectomy rate, and influencing factors for therapeutic effect of the NovaSure endometrial ablation procedure in abnormal uterine bleeding (AUB).

METHODS

We conducted a retrospective cohort study of 2152 patients from the Department of Gynecology at the Third Xiangya Hospital, CSU from October 2010 to December 2018.

RESULTS

From the first year to the eighth year after operation, annual effective rate was above 95.24%, and the differences were not statistically significant. There are statistically significant differences between the effective and ineffective groups with regard to age, intrauterine polyps, total length of the uterus, systemic coagulation disorder, and preoperative hemoglobin. A multivariate logistic regression analysis showed that the risk factors associated with systemic coagulation disorders (P = 0.027) and high total uterine length (P = 0.003) affected NovaSure efficacy in the treatment of AUB. By December 2019, the postoperative hysterectomy rate was 1.86% (40/2152) and the complication rate was 1.67% (36/2152).

CONCLUSION

NovaSure is a reliable treatment for AUB and serious medical complications because of its simple operation, low amount of bleeding, quick postoperative recovery, and safe and effective short-term and long-term efficacy. However, it should be carefully selected for patients with a total uterus length exceeding 10 cm.

摘要

目的

评估 NovaSure 子宫内膜消融术治疗异常子宫出血(AUB)的效率、术后子宫切除率及影响疗效的因素。

方法

我们对 2010 年 10 月至 2018 年 12 月期间在中南大学湘雅三医院妇科接受治疗的 2152 例患者进行了回顾性队列研究。

结果

术后第 1 年至第 8 年,每年的有效率均在 95.24%以上,差异无统计学意义。有效组和无效组在年龄、宫内息肉、子宫总长度、全身凝血障碍和术前血红蛋白方面存在统计学差异。多因素 logistic 回归分析显示,全身凝血障碍(P=0.027)和子宫总长度高(P=0.003)是影响 NovaSure 治疗 AUB 疗效的危险因素。截至 2019 年 12 月,术后子宫切除率为 1.86%(40/2152),并发症发生率为 1.67%(36/2152)。

结论

NovaSure 是治疗 AUB 的一种可靠方法,因其操作简单、出血量少、术后恢复迅速以及短期和长期疗效安全有效,很少发生严重的医疗并发症。然而,对于子宫总长度超过 10cm 的患者,应慎重选择。