宫腔镜联合自凝刀射频消融子宫内膜治疗围绝经期功能性子宫异常出血的临床疗效分析

目的探讨宫腔镜联合自凝刀射频消融子宫内膜治疗围绝经期子宫功能性异常出血的临床疗效。方法选取2015年2月至2017年2月广东药科大学附属第三医院妇科诊治的81例围绝经期子宫功能性异常出血患者作为研究对象。随机分为观察组与对照组,其中观察组41例,对照组40例。观察组采用宫腔镜联合自凝刀射频消融子宫内膜治疗,对照组在超声引导下采用自凝刀射频消融子宫内膜治疗。观察比较两组患者的有效率、子宫内膜厚度以及Kupperman评分、血清卵泡生成激素(FSH)、黄体生成素(LH)、雌二醇(E2)水平变化情况等。结果观察组平均手术时间、术中出血量同对照组比较,差异无统计学意义(P>0.05);观察组闭经率(65.85%)高于对照组闭经率(42.50%),差异具有统计学意义(χ~2=13.252,P=0.018),观察组总有效率(95.12%)与对照组总有效率(95.00%)比较,差异无统计学意义(χ~2=4.386,P=0.221),但秩和检验,差异无统计学意义(χ~2=4.386,P=0.221);观察组子宫内膜厚度及Kupperman评分与对照组相比,差异具有统计学意义(P<0.05);观察组血清FSH、E2、LH水平较对照组降低更为显著,差异具有统计学意义(P<0.05)。结论采用宫腔镜联合自凝刀消融子宫内膜手术,治疗围绝经期功能性子宫异常出血具有安全有效,可保留患者子宫,能显著提升患者疗效,更为彻底地消融子宫内膜,改善患者更年期综合征,降低血清激素水平,改善患者血清激素紊乱。

Clinical analysis of hysteroscopy combined with self-coagulation knife radiofrequency ablation of endometrium in the treatment of perimenopausal dysfunctional uterine bleeding

Objective To explore the clinical effect of hysteroscopy combined with self-coagulation knife radiofrequency ablation of endometrium in the treatment of perimenopausal dysfunctional uterine bleeding.Methods 81 patients with perimenopausal dysfunctional uterine bleeding in our hospital from February 2015 to February 2017 were selected and randomly divided into observation group(n=41)and control group(n=40).The observation group was treated with hysteroscopy combined with self-coagulation knife radiofrequency ablation of endometrium,and the control group was treated with self-coagulation knife radiofrequency ablation of endometrium under ultrasound guidance.The efficacy,endometrial thickness and Kupperman score,serum follicle-producing hormone(FSH),luteinizing hormone(LH)and estradiol(E2)levels of the two groups were compared.Results There was no statistically significant difference in the mean operating time and intraoperative blood loss between the two groups(P>0.05).The rate of amenorrhoea in the observation group(65.85%)was higher than that in the control group(42.50%),with statistically significant differences(χ2=13.252,P=0.018).There was no statistically significant difference in the total effective rate between the observation group(95.12%)and the control group(95%)(χ2=4.386,P=0.221).There were statistically significant differences in the endometrial thickness and Kupperman score between the two groups(P<0.05).Serum FSH,E2 and LH levels in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).Conclusions Hysteroscopy combined with self-coagulation knife ablation of endometrium is safe and effective in the treatment of perimenopausal dysfunctional uterine bleeding,which can retain the uterus of patients,significantly improve the curative effect,more thoroughly ablate the endometrium,improve menopausal syndrome,reduce the level of serum hormones,and improve the disorder of serum hormones in patients.