宫腔镜电切术治疗异常子宫出血的研究

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Study on women with abnormal uterine bleeding treated by hysteroscopic electric resection

OBJECTIVE: To evaluate the efficacy, prognosis and influences of hysteroscopic electrosurgery in treating abnormal uterine bleeding (AUB). METHODS: Eighty two women with AUB were treated by hysteroscopic electric resection. Among them, 48 cases had submucous myomas, 29 cases endometrial polyps, 4 cases dysfunctional uterine bleeding, and 1 case had submucous myoma and endometrial polyps. RESULTS: The mean time of follow-up was 25.5 months. The effective rate of menstrual flow ameliorated was in 91.5% of the patients. Yet, the percentage of the effective rate was decreased gradually with time. The improved effective rates of dysmenorrhea, midcycle pain, premenstrual symptoms and perimenstrual symptoms were 83.3%, 60.0%, 60.0% and 62.7% respectively. The effective rate of total symptoms improved in endometrial thickness with < or = 5 mm was 91.3%, and that in endometrial thickness with > 5 mm was 63.6%. There is a significant difference between in endometrial thickness with < 5 mm and in endometrial thickness with < 5 mm (P < 0.05). The effective rate of total symptoms improved with drugs suppressing endometrium used in perioperation was 93.8%, and that with no drug used was 72.0%. There is also a significant difference between drug used and no drug used groups (P < 0.05). CONCLUSIONS: Hysteroscopic electric resection in treating AUB improves not only menstrual flow but also perimenstrual symptoms. The effectiveness and prognosis of this operation may be related to endometrial thickness and medical treatment.