功能失调性子宫出血射频治疗和经典手术临床分析

目的探讨射频消融与经典手术治疗功能失调性子宫出血的临床效果。方法 2001年9月至2010年12月经我院确诊的1401例功能失调性子宫出血患者,根据患者病情和生育情况分为2组:731例采用射频治疗(射频组),670例采用经典的全子宫、次全子宫切除术治疗(手术组)。结果射频组治疗前后子宫大小、外周血性激素水平、血流动力学指标变化无统计学差异(P>0.05);治愈93.29%,治疗有效率100%;治疗时间短,以门诊治疗为主、必须住院治疗的只要住院1～4 d,患者恢复快,并发症少。手术组行全子宫、次全子宫切除术后,超声示没有子宫,彩色多普勒超声示没有血流信号,治疗有效率为100%,但是患者需住院,恢复慢,并发症多。结论应根据患者情况采用不同治疗方法。对于需要保留子宫的患者,应首选射频治疗,该方法简单、安全。对于无需保留子宫,或者子宫内膜不典型增生、子宫内膜原位癌、浸润癌患者,可以采用手术方法治疗。

Clinical analysis of the therapeutic effects of radiofrequency ablation and abdominal hysterectomy on dysfunctional uterine bleeding

ObjectiveTo investigate the clinical effects of radiofrequency ablation(RFA)and abdominal hysterectomy on dysfunctional uterine bleeding(DUB).Methods There were a total of 1401 patients diagnosed as DUB in the hospital from Sep.2001 to Dec.2010.In accordance with the patients′ conditions and their reproductive status,they were divided into 2 groups: the RFA group(731 cases) and the abdominal complete/partial hysterectomy group(670 cases).Results For the patients in the RFA group,no significant differences could be seen in womb sizes,levels of peripheral sex hormones and hemodynamic indexes,when comparisons were made between pre-surgery and post-surgery.Cure rate for the patients in this group,was 93.29%,with an effective rate of 100%.Besides treatment time was relatively short,most patients received outpatient treatment and those who should receive inpatient treatment were hospitalized for only 1-4 days.They recovered fast,with few complications.For the patients in the surgery group,after complete and partial hysterectomy,ultrasonography indicated that no wombs could be sighted.Colored Doppler ultrasound detection showed that no signals of blood flow could be detected,also with an effective rate of 100%.However,the patients had to be hospitalized,with slow recovery and more complications.Conclusion Different treatment methods should be chosen in accordance with the patients′ conditions.For those who desired to retain womb,the first choice of treatment was RFA,which featured easy manipulation and safety.For those patients with no desire to retain womb,or with atypical hyperplasia of endometrium,carcinoma in situ of endometrium and infiltrating carcinoma,surgery was an ideal method of treatment.