诺舒子宫内膜去除术治疗伴有严重内科合并症的异常子宫出血  

NovaSure Endometrium Removal in the Treatment of Abnormal Uterine Bleeding With Severe Medical Complications

作　　者：李芳[1] 唐江萍[1] 姜丽[1] 曹云桂[1] 程明军[1] 张宇雨 Li Fang;Tang Jiangping;Jiang Li(Department of Gynaecology, Shanghai Jiading District Maternal and Child Health Hospital, Shanghai 201821, China)

机构地区：[1]上海市嘉定区妇幼保健院妇科,上海201821

出　　处：《中国微创外科杂志》2020年第11期1000-1004,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：上海市医学重点专科(ZK2015B08)。

摘　　要：目的探讨诺舒(NovaSure)治疗伴有严重内科合并症的异常子宫出血的安全性和有效性。方法回顾性分析2011年5月~2019年7月诺舒治疗异常子宫出血90例资料,其中合并严重内科疾病31例(A组),未合并严重内科疾病59例(B组)。比较2组围术期指标及术后闭经率、有效率、手术满意率。结果90例均顺利完成手术,其中B组2例术后1个月切除子宫(1例因子宫内膜不典型增生,1例术后出血行宫腔镜电切时子宫穿孔)。随访88例,术后6、12、24、36、48、60个月闭经率70.4%~72.6%,有效率94.4%~97.0%,手术满意率95.7%~97.7%。术后3个月,血红蛋白由术前(99.7±21.1)g/L升高至(111.6±10.2)g/L(P<0.05),子宫内膜厚度由术前(7.6±2.9)mm降低至(4.8±0.8)mm(P<0.05)。A、B组手术时间、术后并发症、再次手术率以及术后半年的闭经率、有效率、手术满意率差异均无显著性(P>0.05)。结论诺舒子宫内膜去除术治疗异常子宫出血安全、有效、可行,同样适用于合并严重内科疾病者。Objective To investigate the safety and efficacy of NovaSure in the treatment of abnormal uterine bleeding with severe medical complications.Methods The data of 90 cases of abnormal uterine bleeding treated with NovaSure from May 2011 to July 2019 were retrospectively analyzed.Among them,31 cases were complicated with serious medical diseases(group A),and there were 59 cases without serious medical diseases(group B).The perioperative indexes,postoperative amenorrhea rate,effective rate and satisfaction rate were compared between the two groups.Results The operations were successfully completed in all the 90 patients.Two patients in the group B underwent hysterectomy 1 month after operation(1 case because of endometrial dysplasia,and another due to uterine perforation during hysteroscopy).The rate of amenorrhea was 70.4%-72.6%in 88 cases who were followed at 6,12,24,36,48,and 60 months after operation.The effective rate was 94.4%-97.0%,and the surgical satisfaction rate was 95.7%-97.7%.Three months after surgery,the hemoglobin was increased from(99.7±21.1)g/L before surgery to(111.6±10.2)g/L(P<0.05).The endometrial thickness was decreased from(7.6±2.9)mm to(4.8±0.8)mm(P<0.05).There were no statistically significant differences between the two groups in operation time,postoperative complications,re-operation rate,amenorrhea rate,effective rate and operation satisfaction rate six months after operation(P>0.05).Conclusions NovaSure endometrial removal is safe,effective and feasible for the treatment of abnormal uterine bleeding.It is also applicable to patients with severe medical diseases.

关 键 词：第二代子宫内膜去除术 诺舒 异常子宫出血 内科合并症 

分 类 号：R71[医药卫生—妇产科学]