诺舒阻抗控制子宫内膜切除治疗肝病合并异常子宫出血30例  

NovaSure System for Abnormal Uterine Bleeding Complicated with Hepatopathy:a Report of 30 Cases

作　　者：刘青[1] 张华[1] 刘继娟[1] 李秀兰[1] 蒋小英[1] 宋晓红[1] 王恩杰[1] 

机构地区：[1]首都医科大学附属北京佑安医院妇产科,北京100069

出　　处：《中国微创外科杂志》2014年第4期304-307,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：北京市乙型肝炎临床数据库和样本资料库建设(D131100005313004)

摘　　要：目的：探讨诺舒（ NovaSure ）阻抗控制子宫内膜切除治疗肝病患者异常子宫出血的安全性、有效性。方法2012年3月～2013年5月，对30例肝病合并异常子宫出血，先行宫腔镜检查，了解宫腔情况（合并黏膜下子宫肌瘤、内膜息肉及子宫中隔者在宫腔镜下电切除），然后采用诺舒治疗，治疗后再次宫腔镜检查，观察治疗效果。术后1、3、6、12个月门诊随访，观察疗效、并发症和满意率。结果30例均顺利完成手术，诺舒治疗时间25～119 s，（63．3±19．8） s；术中出血＜10 ml。术中及术后均无严重并发症发生，2例术后出现轻微下腹痛，自行缓解。术后1、3、6、12个月有效率分别为100％（30/30）、100％（30/30）、100％（24/24）和100％（16/16）；闭经率分别为70．0％（21/30）、66．7％（20/30）、79．2％（19/24）和68．9％（11/16）；满意率均为100％。结论诺舒操作简单且安全，疗效好，适用于肝病合并异常子宫出血患者，尤其适用于严重肝病的患者。Objective To investigate the safety and efficacy of NovaSure system for patients with abnormal uterine bleeding （AUB） complicated with hepatopathy. Methods From March 2012 to May 2013,30 patients with AUB complicated with hepatopathy underwent hysteroscopy examination （ submucosal uterine fibroids , endometrial polyps and uterine mediastinum were resected under hysteroscope ） and NovaSure treatment , and then hysteroscopy was used again to observe the therapeutic effect .The clinical effect, complications and satisfaction rate of patients were observed at 1st, 3rd, 6th, and 12th month after operation. Results All the procedures were completed successfully .The mean operation time of NovaSure was （63.3 ±19.8） s （ range, 25-119 s）;the intraoperative blood loss was less than 10 ml.No intraoperative or postoperative complications occurred .Two cases had slight hypogastralgia and relieved without treatment afterwards .The effective rate was 100%（30/30）, 100%（30/30）,100%（24/24）, and 100%（16/16） at 1st, 3rd, 6th, and 12th month after operation, respectively;the rate of amenorrhea was 70.0%（21/30）, 66.7%（20/30）, 79.1%（19/24）, and 68.8%（11/16）, respectively.The satisfaction rate of patients was 100%. Conclusion NovaSure system is simple, safe and effective for patients with AUB complicated with hepatopathy , especially for patients with severe liver disease.

关 键 词：诺舒 肝病 子宫内膜去除术 异常子宫出血 

分 类 号：R737.33[医药卫生—肿瘤]