摘要
目的探讨第2代（温度控制）射频消融子宫内膜切除术的疗效、安全性和可行性。方法2004年9月-2006年2月由上海市4家医院联合开展一项多中心、前瞻性研究,完成功能性子宫出血温控射频消融子宫内膜切除术81例。在超声监护下,射频治疗以温度控制模式输出功率50 W、温度设定85℃,按照两侧宫角、宫底、宫体、下段部位顺序射频消融子宫内膜。每个治疗点治疗时间为4 min。结果81例术后随访4-17个月。术后6个月随访70例,其中闭经48.6%（34/70）,点滴状月经41.4%（29/70）,少量月经10%（7/70）,总有效率为100%（70/70）。术后12个月随访67例,其中闭经56.7%（38/67）,点滴状月经29.9%（20/67例）,少量月经9.0%（6/67）,正常月经量3.0%（2/67）,月经量过多1.5%（1/67）,总有效率98.5%（66/67）。结论温控射频消融子宫内膜切除术不仅使患者的异常子宫出血在保留子宫的情况下得到有效的治疗,同时具有操作方便、治疗时间短、并发症少、术后恢复快等特点。
Objective To explore the effectiveness, safety and feasibility of the second generation temperature-controlled radiofrequency thermal ablation for resection of the endometrium. Methods A prospective,multi-center study was conducted in four medical center in Shanghai from September 2004 to February 2006. Temperature-controlled radiofrequency thermal ablation was performed in 81 women suffered from dysfunctional uterine bleeding. Under ultrasonography monitoring, the treatment was performed according to the sequence of bilateral uterine horn, fundus of uterus, body of uterus and lower uterine segment, with the output power at 15 W and the temperature at 85 2℃ by means of temperature-controlled mode. The treatment time of one point was 4 minutes. Results 81 patients was followed up for 4 - 17 months. The 6-month follow-up in 70 patients showed that the rate of amenorrhea, spotting menstruation, scanty menstruation was 48.6% （34/70） ,41.4% （29/70） , 10% （7/70） , respectively, with the total effective rate being 100% （70/70）. And the 12-month follow-up in 67 patients revealed that the rate of amenorrhea, spotting menstruation, scanty menstruation, normal menses, profuse menstruation was 56.7% （ 38/67 ） , 29.9% （ 20/67 ） , 9.0% （ 6/67 ） , 3.0% （ 2/67 ） , 1.5% （1/67）, respectively, with the total effective rate being 98. 5% （66/67）. Conclusions Temperature-controlled radiofrequency thermal ablation for resection of the endometrium is an effective and safe technique in the treatment of abnormal uterine bleeding with preserving uterine. It has the advantages of simple procedure, shorter treatment time, less complications and quicker recovery.
出处
《中国微创外科杂志》
CSCD
2007年第10期979-981,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
射频消融
子宫内膜切除术
功能失调性子宫出血
Radiofrequency ablation
Resection of the endometrium
Dysfunctional uterine bleeding
