摘要
目的:对182例应用Therm ab lateTMEASTM子宫内膜热球剥除术(uterine balloon therapy,UBT)或经宫颈内膜电切术的手术患者进行为期两年的随访、对比研究。方法:2003年10月至2005年6月在北京大学人民医院和北京天坛医院被施行UBT的90例患者为UBT组;同期92例经宫颈子宫内膜电切术(transcervical resection of endo-m etrium,TCRE)患者为TCRE组。平均年龄:UBT组49.4±9.4(34~81)岁,TCRE组46.6±8.4(35~74)组。平均随访时间:UBT组17.3±5.0(6~27)个月,TCRE组17.5±4.1(6~27)个月。两组患者术前并发症比较差异无统计学意义。对两组所有患者术后1个月及每半年门诊随访,2005年12月专人电话随访。结果:比较两组患者术中疼痛χ2=12.744,P=0.000,差异有统计学意义,UBT组疼痛重于TCRE组;比较两组术后血净天数,χ2=24.347,P=0.000,有统计学意义,UBT组血净天数少于TCRE组;两组分泌物持续天数比较χ2=99.486,P=0.000,有统计学意义,UBT组分泌物持续天数少于TCRE组;两组术后两年月经血量比较,χ2=4.708,P=0.03,差异有统计学意义,UBT组的改善优于TCRE组;两组术后痛经改善程度比较,χ2=9.970,P=0.002,差异有统计学意义,UBT组的改善优于TCRE组;两组手术满意度比较,χ2=4.719,P=0.094,差异无统计学意义。术后UBT组宫腔形态“正常化”,而TCRE组宫腔呈典型的“筒状”,双侧输卵管开口不显露。结论:UBT是新一代的子宫内膜剥除术,其围术期疼痛重于TCRE,但可口服止痛药缓解;UBT组血净天数、分泌物持续天数短于TCRE组,术后两年月经血量和痛经改善优于TCRE组,但其更长期的有效性有待临床证实。
Objective： To study the two-year follow-up and contrast research for 182 patients by ThermablateTM EASTM Uterine Balloon Therapy （UBT） or Transcervical Resection of Endometrium （TCRE）. Methods： We followed up 90 cases of UBT and 92 cases of TCRE between Oct. 2003 and June 2005. The mean age of UBT group was 49.4 ±9.4 （34 - 81 ） yrs, and that of TCRE group 46.6 ± 8.4 （35 -74） yrs. The mean following-up for UBT group was 17.3 ±5.0 （6 -27） months, and that of TCRE group 17.5 ± 4.1 （6 -27） months. There was no noticeable difference of the high risk for complication between the two groups. The follow up happens twice a year one month after the operation. The follow up started in Dec. 2005. Results. The χ^2 value of pain during operation between two groups is 12. 744. The P value is 0.000. It has statistical significance. The pain of UBT group is heavier than TCRE. The χ^2 value of blood disappearance between two groups is 24.347. The P value is 0.000. It has statistical significance. The duration of the blood disappearance of UBT group is shorter than TCRE. The χ^2 value of discharge disappearance between two groups is 99.486. The P value is 0.000. It has statistical significance. The duration of the blood discharge of UBT group is shorter than TCRE. The χ^2 value of blood flow for two years after surgery between two groups is 4. 708. The P value is 0.03. It has statistical significance. The blood flow of UBT group is much more decrease than TCRE. The χ^2 value of dysmenorrheal improved after surgery between two groups is 9.970. The P value is 0.002. It has statistical significance. The dysmenorrheal improved of UBT group is much better than TCRE. Conclusion：Thermablate^TM EAS^TM UBT is a new generation of endometrial ablation . Two years clinical observation shows that pain can be controlled by oral medicine for UBT group. The blood and discharge disappearance of UBT group is shorter than TCRE. Two years after the surgery the improvement of blood flow and dysmenorrheal released is much better than TCRE. However it probably will take longer time to show its long term effectiveness.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2006年第4期432-435,共4页
Journal of Peking University:Health Sciences
关键词
子宫内膜
物理治疗技术
电外科手术
Endometrium
Physical therapy techniques
Electrosurgery
