诺舒阻抗子宫内膜切除系统治疗异常子宫出血后存在的问题及防治

Problems and its prevention and cure strategies of NovaSure system for patients with abnormal uterine bleeding

目的探讨诺舒(NovaSure)阻抗控制子宫内膜切除系统治疗异常子宫出血(AUB)后存在的问题及防治方法。方法选择2011年8月至2016年2月,在常州市中医医院妇产科采取诺舒阻抗子宫内膜切除系统治疗AUB,并在随访过程中出现相关临床症状的6例患者为研究对象。对其临床资料进行回顾性分析,并通过随访发现存在的问题,分析导致这些问题的可能原因及防治方法。结果本组接受诺舒阻抗子宫内膜切除系统治疗的6例AUB患者中,1例出现反复下腹痛,2例出现异常阴道排液,3例再次出现AUB。宫腔镜检查可见宫腔黏连,子宫壁瘢痕样改变,宫腔内血块及坏死组织,重者子宫内膜恶性改变。结论诺舒阻抗子宫内膜切除系统治疗AUB后,存在的临床问题需积极防治。

ObjectiveTo investigate the problems of NovaSure system impedance controlled endometrial ablation system for abnormal uterine bleeding （AUB） and how to control and prevent it.MethodsFrom August 2011 to February 2016, a total of 6 AUB patients who took NovaSure system treatment in department of Obstetrics and Gynecology of Changzhou TCM Hospital, and had some clinical symptoms during the follow-up were included in the study. The clinical data were analyzed retrospectively, and the existing problems were found during the follow-up. Moreover, we analyzed the possible reasons of these problems and the prevention strategies.ResultsAfter NovaSure system treatment for these 6 AUB patients, there were 1 patient had hypogastralgia repeatedly, 2 patients had abnormal vaginal discharge and 3 patients had AUB again. Hysteroscopy showed the intrauterine adhesions, uterine wall scar like changes, intrauterine blood clots and necrotic tissue, even endometrial malignant change.ConclusionsAfter NovaSure system treating of AUB, there are some clinical problems which need to be controlled and prevented actively.