射频消融子宫内膜去除术治疗异常子宫出血2年随访报告  

Radiofrequency induced thermal endometrial ablation in treatment of menorrhagia:a 2 years follow-up

作　　者：刘晓军[1] 刘彦[1] 金志军[1] 黄腊梅[1] 陈静[1] 

机构地区：[1]第二军医大学附属长征医院妇产科,上海200003

出　　处：《上海医学》2008年第5期320-322,共3页Shanghai Medical Journal

摘　　要：目的探讨射频消融子宫内膜去除术(REA)治疗异常子宫出血的远期疗效。方法选择36例药物治疗无效、无生育要求的异常子宫出血行REA治疗的患者。于术后6个月、2年观察月经情况,并行宫腔镜观察子宫内膜,其中12例患者取内膜行病理检查。结果术后6个月闭经22例(61.1%),月经量减少8例(22.2%),月经量正常4例(11.1%),无效2例(5.5%),总有效率为94.4%(34/36)。术后2年,有2例闭经患者有少量阴道出血,其余患者月经情况无明显变化,总有效率不变。宫腔镜下,2例闭经患者的子宫内膜呈纤维化、瘢痕状;少量阴道出血者局部有岛状子宫内膜;月经量正常者在纤维化和瘢痕组织中多处有子宫内膜覆盖。结论REA治疗异常子宫出血远期疗效满意。Objecive To explore the long-term curative effects of radiofrequency induced thermal endometrial ablation （REA） in treatment of abnormal uterine bleeding. Methods A total of 36 patients with menorrhagia, who had failed to respond to drug therapy and no longer desired pregnancy, were treated by REA. They were inquired some questions about menstruation at 6 months and 2 years after operation and received hesteroscope; 12 patients also agreed to have endometrial biopcy. Results Six months after treatment 22 （61. l%）cases showed amenorrhea,8 （36.3 %） showed scanty menstruation, 4 （ 11. 1 % ） had normal menstruation, and no improvement was seen in 2 （5.5%）cases, with the total effective rate being 94.4%. Two years after operation 2 of 22 amenorrhea cases had minor bleeding, and the rest patients had no changes, with the total effective remained unchanged. Hesteroscope revealed that the endometria of amenorrhea had scar or fibrosis. Patients with scanty menstruation had island like endomentia; and those with normal menstruation had multiple endomential coverage. Conclusions The long-term curative effect of REA for treatment of annomal menorrhagia is satisfactory. （Shanghai Med J, 2008, 31： 320-322）

关 键 词：异常子宫出血 射频消融 子宫内膜去除术 

分 类 号：R713[医药卫生—妇产科学]