慢性肾衰竭合并异常子宫出血患者行血液透析联合诺舒阻抗控制子宫内膜切除术治疗效果研究  

Analysis of the effect of HD combined with NovaSure in patients with chronic renal failure and abnormal uterine bleeding

作　　者：蔡真理 周萍萍 王志红 岑子娟 陈爱红 肖利平 CAI Zhen-li;ZHOU Ping-ping;WANG Zhi-hong;CEN Zi-juan;CHEN Ai-hong;XIAO Li-ping(Jiangnan Hospital,Affiliated Zhejiang University of Traditional Chinese Medicine,Hangzhou 311200,China)

机构地区：[1]浙江中医药大学附属江南医院,浙江杭州311200

出　　处：《中国实用妇科与产科杂志》2023年第10期1035-1038,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：浙江省中医药科技计划项目(2021ZB241)。

摘　　要：目的 探讨慢性肾衰竭合并异常子宫出血(abnormal uterine bleeding,AUB)患者行血液透析(hemodialysis,HD)联合诺舒阻抗控制子宫内膜切除术(NovaSure手术)治疗对肾功能、子宫内膜厚度及雌激素水平的影响。方法选取2019年1月至2022年12月浙江中医药大学附属江南医院收治的慢性肾衰竭(代偿期)合并AUB患者275例,所有患者均行连续性HD治疗,采用随机数字表法分为2组:对照组(n=137)在HD基础上行宫腔镜子宫内膜电切术治疗,研究组(n=138)在HD基础上行NovaSure手术治疗。采用凯氏定氮法检测血尿素氮(blood urea nitrogen,BUN)表达,碱性苦味酸终点比色法检测血肌酐(Serum creatinine,Scr)表达,阴道超声测量子宫内膜厚度,荧光素酶检测法检测雌激素受体(estrogen receptorα,ER)表达,分析两组上述指标差异。结果 术后3、12个月时两组BUN、Scr表达水平差异均无统计学意义(P>0.05);子宫内膜厚度、ER表达水平研究组均低于对照组,差异有统计学意义(P<0.05)。结论 慢性肾衰竭合并AUB患者雌激素表达异常、子宫内膜变厚,采用HD联合NovaSur手术治疗有较好的调节作用,可促进雌激素表达恢复,降低子宫内膜厚度,且对肾功能无影响。Objective To explore the effects of hemodialysis(HD)combined with NovaSure Endometrial Ablation System(NovaSure)on renal function,endometrial thickness,and estrogen levels in patients with chronic renal failure and abnormal uterine bleeding.Methods A total of 275 patients with abnormal uterine bleeding combined with renal failure(compensatory stage)admitted to Jiangnan Hospital,Affiliated Zhejiang University of Traditional Chinese Medicine from January 2019 to December 2022 were selected as the study objects.All subjects received continuous HD treatment and were grouped by random number table method.The control group(n=137)received basic ascending endometrial resection treatment for HD treatment.The study group(n=138)was treated with NovaSure on the basis of HD.Blood urea nitrogen(BUN)expression was determined by Kjell nitrogen assay,serum creatinine(Scr)expression was determined by alkaline picric acid endpoint colorimetry,and endometrial thickness was measured by vaginal B-ultrasound.The expression of estrogen receptorα(ER)was detected by luciferase assay and the differences between the two groups were analyzed.ResultsAt 3 and 12 months after operation,there was no statistically significant difference in the expression levels of BUN and Scr between the two groups(P>0.05);The endometrial thickness and ER expression level in the study group were lower than those in the control group,with statistically significant differences(P<0.05).Conclusion Patients with abnormal uterine bleeding have abnormal estrogen expression,and the endometrium is thickened.HD combined with NovaSur treatment has a good regulating effect,promoting the recovery of estrogen expression,and reducing the endometrial thickness,and it has no impact on renal function.

关 键 词：慢性肾衰竭 异常子宫出血 诺舒阻抗控制子宫内膜切除术 肾功能 子宫内膜厚度 雌激素 

分 类 号：R711.52[医药卫生—妇产科学]