微波子宫内膜去除术治疗月经过多预后影响因素分析  

Prognosis Factors of Microwave Endometrial Ablation in the Treatment of Menorrhagia

作　　者：李荔[1] 罗喜平[1] 陈文静[1] 陈伟芳[1] 曾俐琴[1] 和秀魁[1] 

机构地区：[1]广东省妇幼保健院妇科,广东广州510010

出　　处：《广州医学院学报》2009年第3期31-34,共4页Academic Journal of Guangzhou Medical College

摘　　要：目的:探讨影响微波子宫内膜去除术治疗月经过多预后的因素。方法:选择因月经过多药物治疗无效而行微波子宫内膜去除术(MEA)治疗患者共334例。术后随访患者的月经状况、手术疗效及术后症状复发再次干预治疗情况,术后平均随访时间64.7个月(3-115个月)。结果:MEA治疗月经改善总有效率为91.3%(305/334),其中闭经率为49.7%(166/334),月经量减少为41.6%(139/334);术后痛经改善的有效率为71.1%(140/197);患者对手术的满意率为91.9%(307/334);术后因症状复发等行再次干预治疗42例(12.6%,42/334),其中行二次MEA9例,子宫切除33例。结论:MEA治疗月经过多安全、有效。对子宫内膜的不完全破坏导致宫角残留岛状子宫内膜是术后复发的重要原因。年龄、合并子宫腺肌症是影响MEA手术远期成功率的主要因素。Objective ：To identify prognosis factors of menorrahgia treatment using microwave endometfial ablation （MEA）. Methods：334 women with menorrhagia were selected for MEA. All the patients were followed up,the change of menstrual cycle, therapeutic effect of the procedure, and recurrent cases undergoing repeat surgery were recorded. The mean duration of follow-up was 64.7 months （ 3 - 115 months ）. Results： Total effective rate was 91.3 % , in which amenorrhea rate was 49. 7% , menstruation reduction rate was 41. 6% ; 71. 3% of the cases who previously had dysmeuorrheal had relieved their pain and the satisfaction rate was 91.9% ; Forty-two cases required subsequent treatment as a result of recurrence, of which 9 cases were given repeat MEA and 33 cases underwent hysterectomy. Conclusion：MEA is characterized by simplicity of its performance, marked effectiveness. Cornual vestigital island shape endometrium caused by incomplete removal of endometrium was the important factor in recrudesce,young age and adenomyosis showed significant increased risk of treatment failure. Standardizing the procedure and strengthening postoperative management are essential requirements for improving the effectiveness of MEA.

关 键 词：微波子宫内膜去除术 月经过多 远期疗效 预后 

分 类 号：R711.51[医药卫生—妇产科学]