诺舒子宫内膜去除术治疗异常子宫出血的预后影响因素分析#br#

Prognosis factors of NovaSure endometrial ablation in the treatment of abnormal uterine bleeding

Objective?To investigate the prognostic factors of NovaSure endometrial ablation in the treatment of abnormal uterine bleeding (AUB). Methods?A retrospective analysis was performed on 201 patients with AUB who underwent NovaSure endometrial ablation in our hospital from January 1, 2011 to December 31, 2018. We analyze the amenorrhea rate and the rate of reintervention at different time points after operation. Cox regression model was used to investigate the factors that influenced the outcome (amenorrhea rate) and treatment failure (reintervention rate). Results?The amenorrhea rate was 67.66%, 70.27%, 76.32%, 75.83%, 78.82% at 1, 2, 3, 4 and 5~8 years after NovaSure operation respectively. The re-intervention rate was 6.47%, 10.27%, 14.47%, 15.00%, 18.82%, respectively.  Multivariate analysis by Cox regression model was used to study the prognostic factors .AUB patients with the history of cesarean section (P=0.026, HR=0.588, 95%CI: 0.368~0.938) or the cases combined with adenomyosis (P=0.007, HR=0.424, 95% CI: 0.227~0.792) can reduce the rate of amenorrhea, which affected the curative effect of NovaSure operation. AUB patients with dysmenorrhea history (P=0.008, HR=3.239, 95% CI: 1.356~7.736) or combined with adenomyosis (P<0.0001, HR=4.952, 95% CI: 2.297~10.678) or with thicker endometrial (thickness>10 mm, P=0.021, HR=2.413, 95% CI: 1.139~5.111) can increase the postoperative re-intervention rate, which are the risk factors for failure of NovaSure operation. Conclusion?The history of cesarean section and adenomyosis can reduce the rate of amenorrhea, which affected the curative effect of NovaSure operation; Dysmenorrhea, adenomyosis and endometrial thickness 10 mm can increase the postoperative re-intervention rate and were the risk factors of NovaSure operation failure.