微波子宫内膜去除术组织损伤的研究

Tissue injury study of microwave endometrial ablation

目的探讨微波子宫内膜去除术(MEA)中微波的不同作用方式对子宫组织损伤的程度。方法于月经后早卵泡期分别对离体和在体子宫行MEA。设置MEA作用过程中微波探头"Z"形烧灼宫腔或"Z+W"形烧灼宫腔,将作用后的子宫标本进行HE、尼可酰胺腺嘌呤核苷酸-黄递酶(NADH-d)染色,观察组织热损伤的改变并测量热损伤深度。结果采用"Z"形和"Z+W"形烧灼方法行MEA,对子宫体的组织破坏深度可达4.0～6.2mm。"Z+W"形烧灼的组织损伤深度明显深于"Z"形烧灼者(P<0.05)。结论"Z+W"形烧灼宫腔,内膜破坏充分是适宜的MEA作用方法。

[Objective] To investigate the tissue injury during microwave endometrial ablation （MEA）. [Methods] The operation was performed in the follicular phase, when performing endometrial resection in vitro or in vivo, the applicator radiating microwaves was moved by ＂Z＂ or ＂Z＋W＂ shape motion inside uterine cavity. After operation the uterine specimens were stained by hemaloxylin-eosin, and respiratory enzyme dehydronicotinamide adenine dinucleotide phosphate diaphorase （NADH-d） methods for evaluating the tissue damage. [Results] With two method of applicator radiating microwaves, the depth of tissue thermal damage is 4.1-6.2mm （2）The injury depth of the ＂Z＋W＂ radiated group had increased significantly than that of the ＂Z＂ radiated group. [Conclusion] It is the ideal performing method that the applicator radiating microwaves moved by ＂Z＋W＂ shape motion inside uterine cavity.