宫腔镜子宫内膜电切治疗功能失调性子宫出血的临床疗效及影响因素(1)
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[摘要] 目的：探讨宫腔镜子宫内膜电切(TCRE)治疗功能失调性子宫出血的临床疗效及影响因素。方法：本院2008年7月～2010年8月共收治功能失调性子宫出血患者62例，对符合手术指征的50例患者进行TCRE治疗，观察手术时间、术中出血量、术后并发症的发生情况及临床疗效，并同时检测术前和术后血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)和孕酮(P)等激素水平。术后随访6个月，探讨影响治疗效果的相关因素。结果：术前和术后激素水平比较差异无统计学意义(P>0.05)；术后随访6个月，总有效率为94.0%，并发症发生率为8.0%。结论：TCRE治疗功能失调性子宫出血的临床疗效确切，不良反应少，宫腔深度、年龄及病程长短是影响临床疗效的主要因素。
[关键词] 宫腔镜；子宫内膜电切；功能失调性子宫出血；因素
[中图分类号] R711.52 [文献标识码]A[文章编号]1674-4721(2011)03(b)-021-02
Hysteroscopic endometrial resection treatment of dysfunctional uterine bleeding effect and influence factors
ZENG Renjiao
Xiangtan City Hospital of Hunan Province, Xiangtan 411100, China
[Abstract] Objective: To investigate the hysteroscopic endometrial resection (TCRE) treatment of dysfunctional uterine bleeding effect and factors. Methods: Our hospital from July 2008 to August 2010 dysfunctional uterine bleeding were treated in 62 patients, in line with indications for surgery, 50 patients were TCRE treatment, operation time, blood loss, postoperative complications the occurrence and clinical effect, and simultaneous detection of preoperative and postoperative serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and progesterone (P) and other hormone levels. Were followed up for 6 months to explore the factors affecting the therapeutic effect. Results: Preoperative and postoperative hormone levels were no significant differences (P>0.05); were followed up for 6 months, the total effective rate was 94.0%, complication rate was 8.0%. Conclusion: TCRE treatment of dysfunctional uterine bleeding of clinical efficacy, adverse reactions, uterine cavity depth, age and disease duration are the main factors affect the clinical efficacy.
[Key words] Hysteroscopy; Endometrial resection; Dysfunctional uterine bleeding; Factors
功能失调性子宫出血是指由于功能失调并非器质性病变引起的异常子宫出血，简称功血。按发病机制可分为无排卵性和排卵性功血两大类，前者占70%～80%，多见于青春期及绝经过渡期妇女，后者占20%～30%，多见于育龄妇女，病情严重时可导致失血性贫血，降低生活质量，甚至威胁健康[1]。本院2008年7月～2010年8月采用宫腔镜子宫内膜电切(TCRE)治疗功能失调性子宫出血50例，取得了良好效果，本文就其治疗效果及影响治疗效果的相关因素报道及探讨如下：
1 资料与方法
1.1 一般资料
50例TCRE治疗患者，年龄33～55岁，产次1～3次，病程7～24个月，血红蛋白(Hb)61～113 g/L，宫腔深度7～11 cm。病理检查发现增殖期子宫内膜17例，分泌期子宫内膜13例，非同步子宫内膜12例，单纯性增生7例，复杂型增生1例。均表现为月经过多或月经周期性紊乱，伴有不同程度的贫血，经保守治疗无效，不愿切除子宫 ......
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