热盐水循环灌注去除子宫内膜的实验研究

Experimental study of intrauterine instillation of heated saline for endometrial ablation in swine

目的子宫内膜热疗术是近年应用于临床的治疗功能失调性子宫出血的一项新技术。现通过动物实验探索在治疗温度恒定的情况下,内膜损伤的深度随治疗时间不同的变化规律,以指导临床应用。方法本实验将15只成熟雌性小型猪随机分为3组,分别用热0.9%氯化钠溶液循环灌注宫腔,灌注时间分别为5、8、10 min,操作完毕后切除子宫,取子宫全层标本行病理学、免疫组织化学及电镜检查。结果随灌注时间的不同,子宫内膜出现充血、水肿、苍白的改变。子宫浆膜面温度上升程度及内膜热损伤深度均与灌注时间呈正相关,有高度统计意义(P<0.01)。电镜观察见受累组织细胞呈不同程度的变性坏死改变。结论子宫内膜热疗术是一种安全、有效的治疗功血的方法。可以根据术前情况适当调整治疗时间。

Objective To investigate the effect and safety of hydro-thermotherapy （HTA） in endometrial ablation of swine. Methods Fifteen female mature miniature swine were divided into 3 groups, the circulated 0.9% heated saline was installed into the uterine cavity for 5 rain, 8 rain or 10 rain respectively. The uterine specimens were prepared for hematoxylin-eosin （HE） staining and nitroblue tetrazolium（NBT） staining, the routine histopathological examination, immunohistochemical examination and transmission electron microscopic examination were performed. Results The heated saline treatment lead to endometrial changes, including congestion, edema and pallescence. The degree of temperature rising and the mean depth of endometrial thermal injury were positively correlated with treatment time（P 〈0.01 ）. Examination of transmission electron microscope reveals that affected cells underwent degeneration and necrosis in different severities. Conclusion The results suggest that hydrothermo-ablation may be an effective and safe method for dysfunctional uterine bleeding.