两种子宫内膜去除术治疗异常子宫出血的疗效比较

Comparison of the Effect on the Abnormal Uterine Bleeding between Two Kinds of Endometrial Ablations

目的:比较阻抗控制系统与温控系统两种子宫内膜去除术治疗异常子宫出血的临床疗效。方法:选取异常子宫出血的患者共180例,90例接受阻抗控制系统子宫内膜去除术治疗(阻抗组),90例接受温控系统子宫内膜去除术治疗(温控组)。比较两组的手术时间、术中出血量及术后1、3、6、12个月的疗效及并发症等情况。结果:阻抗组的手术时间(1.31±0.15分钟)明显短于温控组(26.75±3.57分钟),阻抗组术后12个月闭经率(81.1%)明显高于温控组(55.7%),两组比较差异有统计学意义(P<0.05)。两组术中出血量、宫腔深度、住院时间、术后腹痛发生率比较,差异无统计学意义(P>0.05)。两组1、3、6、12个月的有效率及术前、术后血红蛋白水平比较,差异均无统计学意义(P>0.05)。结论:采用阻抗控制系统子宫内膜去除术治疗异常子宫出血,手术时间更短,闭经率更高,且手术时间选择不受经期影响,是治疗异常子宫出血的有效方式。

Objective： To compare the clinical effect between two kinds of endometrial ablation：impedance-controlled and temperature-controlled system,on abnormal uterine bleeding. Methods ：180 cases with abnormal uterine bleeding were enrolled and assigned into two groups. 90 cases were treated with imped- ance-controlled system and the other 90 cases were treated with temperature-controlled system. Clinical data of all cases were recorded, including the operation duration, bleeding amount during operation, post-operative effect and post-operative complication. Results：The operation duration in impedance-controlled group（ 1.31 ± 0. 15 min）was significantly shorter than that in temperature-controlled group（26. 75 ±3. 57 min）. The amenorrhea rate in impedance-controlled group was significantly higher than that in temperature-controlled group（81.1% vs 55.7%, P 〈 0.05）. There was no difference between two groups in terms of intraoperative blood loss, uterine cavity length, resident duration or postoperative pain （ P 〉 0.05 ）, There was no difference between two groups in terms of effective rate, improvement of anemia or the incidence of postoperative complication（P 〉 0. 05）. Conclusions. For The operation duration was shorter and the amenorrhea rate was higher for impedance-controlled system. The choice of operation time was not affected by vaginal bleeding or menstruation. Impedance-controlled system should be an effective approach for treatment of abnormal uterine bleeding.