BACKGROUND Microwave endometrial ablation(MEA)is a minimally invasive treatment for menorrhagia.It has been covered by the national insurance in Japan since April 2012,and its demand has been increasing as the importa...BACKGROUND Microwave endometrial ablation(MEA)is a minimally invasive treatment for menorrhagia.It has been covered by the national insurance in Japan since April 2012,and its demand has been increasing as the importance of women’s health has advanced in society.AIM To examine the efficacy of MEA as a treatment option for menorrhagia.METHODS In this study,we retrospectively analyzed 76 patients who underwent MEA between January 2016 and March 2020 in our department.MEA was performed in the lithotomy position,under general anesthesia,and with transabdominal ultrasound guidance,including the entire endometrial circumference while confirming endometrial coagulation.The Microtaze AFM-712 and the Sounding Applicator CSA-40CBL-1006200C were used for MEA,and the endometrium was ablated using a Microtaze output of 70 W and coagulation energization time of 50 s per cycle.The visual analog scale(VAS)was used to evaluate menorrhagia,menstrual pain,and treatment satisfaction.Additionally,the hemoglobin(Hb)levels before and after MEA and associated complications were investigated.RESULTS The average age of the patients was 44.8±4.0 years.While 14 patients had functional menorrhagia,62 had organic menorrhagia,of whom 14 had endometrial polyps,40 had uterine fibroids,and 8 had adenomyosis.The VAS score before MEA and 3 and 6 mo after the procedure were 10,1.3±1.3,and 1.3±1.3,respectively,for menorrhagia and 10,1.3±1.8,and 1.3±1.8,respectively,for menstrual pain,both showing improvements(P<0.001).The MEA Hb level significantly improved from 9.2±4.2 g/dL before MEA to 13.4±1.2 g/dL after MEA(P=0.003).Treatment satisfaction was high,with a VAS score of 9.6±0.7.Endometritis was observed in one patient after surgery and was treated with antibiotics.CONCLUSION MEA is a safe and effective treatment for menorrhagia.展开更多
Objective: Studying sub endometrial vascularity and blood flow in cases using intrauterine contraceptive devices for contraception with and without menorrhagia compared to cases not using intrauterine contraceptive de...Objective: Studying sub endometrial vascularity and blood flow in cases using intrauterine contraceptive devices for contraception with and without menorrhagia compared to cases not using intrauterine contraceptive devices. Methods: Three hundred and fifteen women attending gynecology and family planning outpatient clinics in the maternity hospital, Ain Shams University were included in the study. They were classified into three groups, 105 women using IUCD with menorrhagia (group I), 105 women using IUCD without menorrhagia (group II), and 105 normal controls not using IUCD (group III). After excluding local causes for bleeding, blood disease or any medical disorders, transvaginal ultrasound including three dimensional power Doppler (3DPD) ultrasound was done for all women. Right and left uterine artery pulsatility index (PI) and resistance index (RI) were calculated, subednometrial blood flow RI and PI were obtained then 3DPD Vascular indices (VI, FI and VFI) of subendometrial blood flow were obtained for all cases. Statistical analysis was done to compare between the three groups. Results: A significant statistical difference was found as regards subendometrial vascularity indices, while there was no difference as regards bilateral uterine arteries Doppler indices in the three groups. Conclusion: Subendometrial vascularity in cases of menorrhagia with IUCD was markedly higher than in cases without menorrhagia and cases with no IUCD. 3DPD may be used for selection of cases prior to insertion of IUCD.展开更多
Through the understanding,identification and treatment of menorrhagia,summarizing professor Zhang Xiaofeng’s clinical experience in the treatment of menorrhagia,focusing on the identification of evidence,using“Tong...Through the understanding,identification and treatment of menorrhagia,summarizing professor Zhang Xiaofeng’s clinical experience in the treatment of menorrhagia,focusing on the identification of evidence,using“Tong”as the application,and treating in stages,he prepared Tongjing and Blood Regulating Soup and Tiaoping Tang as the basis for addition and subtraction,to harmonize the organs,qi and blood,Chong Ren and Uterus,in order to restore the balance of yin and yang and the function of Uterus in hiding and diarrhea.展开更多
Objective: to investigate the effect of Gongxuening on multi-phase use after Shanghuan operation. Methods: a total of 64 patients with Shanghuan operation were collected and randomly divided into 32 control groups and...Objective: to investigate the effect of Gongxuening on multi-phase use after Shanghuan operation. Methods: a total of 64 patients with Shanghuan operation were collected and randomly divided into 32 control groups and control groups. The observation group was treated with traditional western medicine, and the observation group was treated with uterine Xuening intervention. The menstrual volume, hemoglobin level, quality of life and prognosis were observed before and after treatment. Results: the curative effect of the two groups was significantly better than that of the control group, and the dimension scores of heme and SF-36 after treatment were higher than those of the normal group. At the last follow-up, the BISF-W score was higher than that of the normal group, while the menstrual period was smaller than that of the normal group, with a significant difference (P < 0.05). Conclusion: with the cooperation of traditional treatment methods, the patients with menstrual hormone after Shanghuan operation can effectively improve the clinical efficacy, menstrual period and hemoglobin, and thus improve the survival and prognosis of patients.展开更多
目的分析益气养血止血方治疗子宫腺肌病月经过多患者的临床获益情况。方法选取子宫腺肌病月经过多患者64例,其均由上海中医药大学附属岳阳中西医结合医院2021年1月—2022年12月所收治,随机数字表法将其分为对照组(32例,接受常规西药治疗...目的分析益气养血止血方治疗子宫腺肌病月经过多患者的临床获益情况。方法选取子宫腺肌病月经过多患者64例,其均由上海中医药大学附属岳阳中西医结合医院2021年1月—2022年12月所收治,随机数字表法将其分为对照组(32例,接受常规西药治疗)和研究组(32例,接受常规西药治疗+益气养血止血方)。两组连续治疗3个月经周期。比较两组临床指标。结果治疗后,对照组发生月经过多15例(46.88%),研究组发生月经过多7例(21.88%),经组间比较,研究组更低(χ^(2)=4.433,P=0.035);治疗后与治疗前比较,两组经期均缩短,子宫内膜厚度、中医证候各项积分、月经量评分、血清糖类抗原125(carbohydrate antigen 125,CA125)水平、月经过多特异性生存质量(multiple sclerosis quality of life questionnaire,MS-QOL)量表各项评分均降低,且研究组变化更显著(两组间治疗后比较)(P<0.05)。结论子宫腺肌病月经过多患者应用益气养血止血方治疗有助于减少月经量,缓解临床症状,缩短经期,改善子宫功能,促进生活质量提升,且安全性高,临床获益显著。展开更多
文摘BACKGROUND Microwave endometrial ablation(MEA)is a minimally invasive treatment for menorrhagia.It has been covered by the national insurance in Japan since April 2012,and its demand has been increasing as the importance of women’s health has advanced in society.AIM To examine the efficacy of MEA as a treatment option for menorrhagia.METHODS In this study,we retrospectively analyzed 76 patients who underwent MEA between January 2016 and March 2020 in our department.MEA was performed in the lithotomy position,under general anesthesia,and with transabdominal ultrasound guidance,including the entire endometrial circumference while confirming endometrial coagulation.The Microtaze AFM-712 and the Sounding Applicator CSA-40CBL-1006200C were used for MEA,and the endometrium was ablated using a Microtaze output of 70 W and coagulation energization time of 50 s per cycle.The visual analog scale(VAS)was used to evaluate menorrhagia,menstrual pain,and treatment satisfaction.Additionally,the hemoglobin(Hb)levels before and after MEA and associated complications were investigated.RESULTS The average age of the patients was 44.8±4.0 years.While 14 patients had functional menorrhagia,62 had organic menorrhagia,of whom 14 had endometrial polyps,40 had uterine fibroids,and 8 had adenomyosis.The VAS score before MEA and 3 and 6 mo after the procedure were 10,1.3±1.3,and 1.3±1.3,respectively,for menorrhagia and 10,1.3±1.8,and 1.3±1.8,respectively,for menstrual pain,both showing improvements(P<0.001).The MEA Hb level significantly improved from 9.2±4.2 g/dL before MEA to 13.4±1.2 g/dL after MEA(P=0.003).Treatment satisfaction was high,with a VAS score of 9.6±0.7.Endometritis was observed in one patient after surgery and was treated with antibiotics.CONCLUSION MEA is a safe and effective treatment for menorrhagia.
文摘Objective: Studying sub endometrial vascularity and blood flow in cases using intrauterine contraceptive devices for contraception with and without menorrhagia compared to cases not using intrauterine contraceptive devices. Methods: Three hundred and fifteen women attending gynecology and family planning outpatient clinics in the maternity hospital, Ain Shams University were included in the study. They were classified into three groups, 105 women using IUCD with menorrhagia (group I), 105 women using IUCD without menorrhagia (group II), and 105 normal controls not using IUCD (group III). After excluding local causes for bleeding, blood disease or any medical disorders, transvaginal ultrasound including three dimensional power Doppler (3DPD) ultrasound was done for all women. Right and left uterine artery pulsatility index (PI) and resistance index (RI) were calculated, subednometrial blood flow RI and PI were obtained then 3DPD Vascular indices (VI, FI and VFI) of subendometrial blood flow were obtained for all cases. Statistical analysis was done to compare between the three groups. Results: A significant statistical difference was found as regards subendometrial vascularity indices, while there was no difference as regards bilateral uterine arteries Doppler indices in the three groups. Conclusion: Subendometrial vascularity in cases of menorrhagia with IUCD was markedly higher than in cases without menorrhagia and cases with no IUCD. 3DPD may be used for selection of cases prior to insertion of IUCD.
文摘Through the understanding,identification and treatment of menorrhagia,summarizing professor Zhang Xiaofeng’s clinical experience in the treatment of menorrhagia,focusing on the identification of evidence,using“Tong”as the application,and treating in stages,he prepared Tongjing and Blood Regulating Soup and Tiaoping Tang as the basis for addition and subtraction,to harmonize the organs,qi and blood,Chong Ren and Uterus,in order to restore the balance of yin and yang and the function of Uterus in hiding and diarrhea.
文摘Objective: to investigate the effect of Gongxuening on multi-phase use after Shanghuan operation. Methods: a total of 64 patients with Shanghuan operation were collected and randomly divided into 32 control groups and control groups. The observation group was treated with traditional western medicine, and the observation group was treated with uterine Xuening intervention. The menstrual volume, hemoglobin level, quality of life and prognosis were observed before and after treatment. Results: the curative effect of the two groups was significantly better than that of the control group, and the dimension scores of heme and SF-36 after treatment were higher than those of the normal group. At the last follow-up, the BISF-W score was higher than that of the normal group, while the menstrual period was smaller than that of the normal group, with a significant difference (P < 0.05). Conclusion: with the cooperation of traditional treatment methods, the patients with menstrual hormone after Shanghuan operation can effectively improve the clinical efficacy, menstrual period and hemoglobin, and thus improve the survival and prognosis of patients.
文摘目的分析益气养血止血方治疗子宫腺肌病月经过多患者的临床获益情况。方法选取子宫腺肌病月经过多患者64例,其均由上海中医药大学附属岳阳中西医结合医院2021年1月—2022年12月所收治,随机数字表法将其分为对照组(32例,接受常规西药治疗)和研究组(32例,接受常规西药治疗+益气养血止血方)。两组连续治疗3个月经周期。比较两组临床指标。结果治疗后,对照组发生月经过多15例(46.88%),研究组发生月经过多7例(21.88%),经组间比较,研究组更低(χ^(2)=4.433,P=0.035);治疗后与治疗前比较,两组经期均缩短,子宫内膜厚度、中医证候各项积分、月经量评分、血清糖类抗原125(carbohydrate antigen 125,CA125)水平、月经过多特异性生存质量(multiple sclerosis quality of life questionnaire,MS-QOL)量表各项评分均降低,且研究组变化更显著(两组间治疗后比较)(P<0.05)。结论子宫腺肌病月经过多患者应用益气养血止血方治疗有助于减少月经量,缓解临床症状,缩短经期,改善子宫功能,促进生活质量提升,且安全性高,临床获益显著。
