射频治疗子宫功能性出血的疗效观察

Effects of radio freguency ablation(RFCA) on paitents with essential uterine bleeding

目的：探讨射频治疗和口服米非司酮2种方法治疗功能失调性子宫出血（DUB）的临床疗效。方法：将207例经诊断性刮宫病理确诊为DUB的患者分成3组：射频组127例，用功率30-35W消融治疗；米非司酮组40例，给予连续口服小剂量米非司酮；对照组40例给予止血。定期检测3组患者的血红蛋白、子宫大小、卵巢性激素水平并随访疗效。结果：射频组和米非司酮组治疗对改善月经、纠正贫血均有效，且2组差异无统计学意义（P〉0．05）。米非司酮组用药后血清卵泡刺激素（FSH）、黄体生成素（IH）、雌二醇（磁）和孕酮（P）的平均水平较用药前均有不同程度的下降，尤以E2、P下降更为明显（P〈0．01），而射频组血清FSH、LH、E2、P的平均水平治疗前后差异无统计学意义（P〉0．05）。结论：米非司酮和射频治疗DUB有效、安全、不良反应小，对原有合并症无影响。米非司酮具有服药简便、安全的优点，但同时具有影响内分泌功能、长期服药后耐药等缺点，射频治疗则能克服米非司酮治疗的不足，成为治疗DUB的一种更为简便、安全、有效、微创的方法。

Objective： To appoach the effects of radio fregueney ablation（RFCA） and mifepristone on patients with dysfunctional uterine bleeding（DUB）, respectively. Methods： Two hundred and seven cases with DUB diagnosed by dilatation and curettage were randomized into three groups： RFCA group, mifepristone group and control group. RFCA group were treated by 30- 35 W radio fregueney ablation, mifepristone group were administrated by low dose of mifepristone and transfusion, and control group were cured by hemostasis only. Hemoglobin, size of uterus, level of sex hormone and curative effects by follow- up study were observed. Results： In RFCA group and mifepristone group, menstruation and anaemia were both better than before and there was no statistical differene between the two groups（P 〉0.05）. Levels of follicle stimulating hormone（FSH）, luteinizing hormone（LH）, estradiol（E2） and progesterone（P） after taking mifepristone were lower than before, especialy E2 and P（P 〈 0.01）. There were no difference of FSH, LH, E2 and P in RFCA group（P 〉0.05）. Conclusions： Both mifepristone and RFCA are both effective, safe and less adverse reactions on DUB. At the same time, mifepristone can degrade endocrine function and strengthen drug resistance. DUB is can avoid the disadvantages of mifepristone administration, and provid a simpler, safer and more effective micrtrauma method.