[1]赵辉 李海霞 边茜 杨保军 冯力民*.诺舒子宫内膜去除术后再次手术干预的原因分析[J].中国微创外科杂志,2023,01(7):507-510.
　Zhao Hui,Li Haixia,Bian Qian,et al.Analysis on Causes of Repeated Surgical Intervention After NovaSure Endometrial Ablation[J].Chinese Journal of Minimally Invasive Surgery,2023,01(7):507-510.
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诺舒子宫内膜去除术后再次手术干预的原因分析()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2023年7期
页码:
507-510
栏目:
临床研究
出版日期:
2023-07-25

文章信息/Info

Title:
Analysis on Causes of Repeated Surgical Intervention After NovaSure Endometrial Ablation
作者:
赵辉 李海霞 边茜 杨保军 冯力民*
(首都医科大学附属北京天坛医院妇产科，北京100070)
Author(s):
Zhao Hui;  Li Haixia;  Bian Qian;  et al.
Department of Obstetrics and Gynecology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
关键词:
异常子宫出血; 诺舒阻抗控制系统; 子宫内膜去除术
Keywords:
Abnormal uterine bleeding; NovaSure impedance controlled system; Endometrial ablation
文献标志码:
A
摘要:
目的探讨诺舒(NovaSure)子宫内膜去除术(endometrial ablation，EA)治疗异常子宫出血(abnormal uterine bleeding，AUB)后再次手术干预的原因及防治方法。方法2011年1月~2018年12月285例AUB在我院行诺舒子宫内膜去除术，术后32例需要再次手术干预，其中20例宫腔镜保守性手术，12例腹腔镜全子宫切除术。结果32例再次干预的原因：AUB 14例(438%)，周期性腹痛或下腹隐痛3例(9.4%)，异常子宫出血合并腹痛15例(46.9%)。再次干预治疗方式：9例宫腔镜检查+诊断性刮宫；4例宫腔镜下宫腔粘连分解术+放置左炔诺孕酮宫内缓释系统（曼月乐）；2例宫腔镜下子宫腺肌瘤病灶切除+放置曼月乐；1例宫腔镜下子宫内膜息肉电切术+放置曼月乐；4例二次EA(滚球子宫内膜去除术)+放置曼月乐；12例腹腔镜全子宫切除术。术后中位数随访时间51(44,88)个月，AUB伴或不伴腹痛症状均得到缓解或消失。结论诺舒子宫内膜去除术后再次手术干预的主要原因为再次子宫出血和(或)下腹痛；B超引导下宫腔镜手术是治疗EA术后并发症安全、有效的方法。
Abstract:
ObjectiveTo investigate causes and prevention of repeated surgical intervention after NovaSure endometrial ablation in the treatment of abnormal uterine bleeding (AUB).MethodsFrom January 2011 to December 2018, there were 285 AUB patients who received NovaSure endometrial ablation in our hospital. After surgery, there were 32 patients given repeated surgical intervention, including 20 cases of conservative hysteroscopic operations and 12 cases of laparoscopic total hysterectomy.ResultsThe causes of reintervention included AUB in 14 cases (43.8%), periodic abdominal pain or lower abdomen dull pain in 3 cases (94%), and AUB accompanied with abdominal pain in 15 cases (46.9%). The reoperations consisted of hysteroscopy plus diagnostic curettage in 9 cases, hysteroscopic adhesiolysis and hormonal intrauterine device (Mirena) placement in 4 cases, hysteroscopic adenomyoma resection and Mirena placement in 2 cases, hysteroscopic resection of endometrial polyps and Mirena placement in 1 case, secondary endometrial ablation (ball endometrial removal) and Mirena placement in 4 cases, and laparoscopic total hysterectomy in 12 cases. The median followup time was 51 (44, 88) months. The symptoms of AUB with or without abdominal pain were alleviated or disappeared.ConclusionsThe main causes for reintervention after NovaSure endometrial ablation are recurrent uterine bleeding and/or lower abdomen pain. Hysteroscopic surgery guided by Bultrasound is a safe, effective and minimally invasive method for the treatment of postoperative complications of endometrial ablation.

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备注/Memo

备注/Memo:
*通讯作者，Email：lucyfeng1966@163.com
更新日期/Last Update: 2023-10-10