射频消融治疗围绝经期功血的临床研究

Clinical study on treatment of uterine bleeding at perimenopause by radiofrequency ablation

目的：探讨自凝刀射频消融子宫内膜（RFAE）在治疗围绝经期功血中的临床疗效。方法：选择2004年1月～2005年1月自愿接受自凝刀射频治疗围绝经期功血患者52例，在B超实时动态监测下，将自凝刀经阴道宫颈置入官腔介入到内膜，治疗后观察术后1个月、3个月、6个月功血患者出血量的改变及定期B超复查，观察子宫大小和子宫内膜情况。结果：52例患者经治疗后，子宫体积均不同程度缩小，术后3个月复查，35例（67．3％）已闭经，13例（25．0％）月经量较前明显减少，4例（7．7％）较前好转；B超探查，35例闭经者无明显内膜，13例较前明显减少者的内膜为2～3mm，4例较前好转者内膜为3～4mm，子宫腔大小、形态与3个月相比无明显改变。6个月复查，完全闭经者49例，占94．2％。月经量明显减少2例，占3．84％，1例较前月经好转，占1．96％。总有效率100％。无1例出现再流血现象。结论：超声引导下射频子宫内膜消融是治疗功血简单、安全、快速、有效、痛苦小的微创介入治疗新技术，可替代子宫切除，值得推广应用。

Objective： To assess the clinical effects in treating obstinate dysfunctional uterine bleeding at perimenopause by radiofrequency endometrial ablation （RFAE） . Methods： Fifty - two patients with dysfunctional uterine bleeding were treated by radiofrequency ablation guided by ultrasound. The uterine sizes were regularly observed as curative effect by ultrasound after therapy. All of them were followed up for. six months. Ultrasound imaging and clinical evaluation were obtained preoperatively and at one, three months. Results： The uterine sizes reduced in all cases comparing the difference of menorrhagia symptom after 1 ～ 6 months, the total effective was 100% and none of the patients bled after operation. Conclusion： Radiofrequency ablation guided by ultrasound is a simple, safe, fast, effective approach and less - suffering new interventional technology in the treatment of dysfunctional uterine bleeding which offers an alternative to hysterectomy and is valuable for popularization and application.