宫腔镜下热盐水循环灌注治疗月经过多疗效初步评价

Preliminary Evaluation of Hysteroscopic Endometrial Ablation Using HTA for the Treatment of Menorrhagia

目的 :探讨宫腔内循环灌注去除子宫内膜术 (HTA)治疗月经过多的临床效果和技术的安全性。方法 :32例月经过多患者接受HTA治疗 ,年龄 4 4 .1± 3.2岁 ,术前宫腔镜检查诊断为单纯型子宫内膜增殖症 14例 ,子宫内膜息肉 11例 ,粘膜下肌瘤 5例 ,腺肌病 2例。结果 :32例均顺利完成HTA手术 ,无严重并发症发生。总手术时间为 2 7.9± 8.6分钟 ,治疗时间为 10分钟。随访 3～ 18个月 ,30例月经过多症状改善 ,其中闭经 34.4 % ,少量月经 4 0 .6 % ,正常量月经18 8% ,治疗总有效率为 93.8%。 2例 (6 .3% )治疗失败者作子宫切除术。结论 :HTA是一种安全有效的子宫内膜切除技术 。

Objective: To evaluate the efficacy and safety of hysteroscopic endometrial ablation for treatment of menorrhagia with hydro-thermablator (HTA).Methods:32 cases with menorrhagia were treated with HTA in our hospital. Their mean age was 44.1±3.2 years. The primary diagnosis included simple hyperplasia (14 cases), endometrium polypus (11 cases), submucous leiomyoma (5 cases), uterine adenomyosis (2 cases). All patients were treated with Danazol or Mifeperistone to induce endometrial atrophy before operation.Results: All patients were performed HTA successfully,and there were no major complications. Total operation time was 27.9±8.6 min and the time of HTA procedure was 10 min. All patients were followed-up for 3～18 months. Menstrual symptoms were ameliorated in 30 cases (93.8%), among them, 34.4% of cases was amenorrheic, 40.6% was hypomenorrheic, and 18.8% was normal menstrual period. Two cases (6.3%) had persistent menorrhagia and then were treated by hysterectomy.Conclusions: HTA is an effective and safe method of ablating the endometrium for treatment of menorrhagia with benign uterine disease.