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1、射頻治療子宮功能性出血的療效觀察作者:戴良圖,張華,許恒,唐大海單位:解放軍第四一一醫(yī)院婦產科,上?!菊磕康模禾接懮漕l治療和口服米非司酮2種方法治療功能失調性子宮出血(DUB)的臨床療效。方法:將207例經(jīng)診斷性刮宮病理確診為DUB的患者分成3組:射頻組127例,用功率30~35W消融治療;米非司酮組40例,給予連續(xù)口服小劑量米非司酮;對照組40例給予止血。定期檢測3組患者的血紅蛋白、子宮大小、卵巢性激素水平并隨訪療效。結果:射頻組和米非司酮組治療對改善月經(jīng)、糾正貧血均有效,且2組差異無統(tǒng)計學
2、意義(P>0.05)。米非司酮組用藥后血清卵泡刺激素(FSH)、黃體生成素(LH)、雌二醇(E2)和孕酮(P)的平均水平較用藥前均有不同程度的下降,尤以E2、P下降更為明顯(P<0.01),而射頻組血清FSH、LH、E2、P的平均水平治療前后差異無統(tǒng)計學意義(P>0.05)。結論:米非司酮和射頻治療DUB有效、安全、不良反應小,對原有合并癥無影響。米非司酮具有服藥簡便、安全的優(yōu)點,但同時具有影響內分泌功能、長期服藥后耐藥等缺點,射頻治療則能克服米非司酮治療的不足,成為治療DUB的
3、一種更為簡便、安全、有效、微創(chuàng)的方法?!娟P鍵詞】射頻治療;月經(jīng)失調;子宮功能性出血;米非司酮Effectsofradiofreguencyablation(RFCA)onpaitentswithessentialuterinebleedingDAILiang-tu,ZHANGHua,XUHeng,TANGDa-hai(No.411HospitalofCPLA,Shanghai200081,China)Abstract:Objective:Toappoachtheeffectsofradiofreg
4、uencyablation(RFCA)andmifepristoneonpatientswithdysfunctionaluterinebleeding(DUB),respectively.Methods:TwohundredandsevencaseswithDUBdiagnosedbydilatationandcurettagewererandomizedintothreegroups:RFCAgroup,mifepristonegroupandcontrolgroup.RFCAgroupwer
5、etreatedby30~35Wradiofreguencyablation,mifepristonegroupwereadministratedbylowdoseofmifepristoneandtransfusion,andcontrolgroupwerecuredbyhemostasisonly.Hemoglobin,sizeofuterus,levelofsexhormoneandcurativeeffectsbyfollow-upstudywereobserved.Results:InR
6、FCAgroupandmifepristonegroup,menstruationandanaemiawerebothbetterthanbeforeandtherewasnostatisticaldifferencbetweenthetwogroups(P>0.05).Levelsoffolliclestimulatinghormone(FSH),luteinizinghormone(LH),estradiol(E2)andprogesterone(P)aftertakingmifepri
7、stonewerelowerthanbefore,especialyE2andP(P<0.01).TherewerenodifferenceofFSH,LH,E2andPinRFCAgroup(P>0.05).Conclusions:BothmifepristoneandRFCAarebotheffective,safeandlessadversereactionsonDUB.Atthesametime,mifepristonecandegradeendocrinefunctionan
8、dstrengthendrugresistance.DUBiscanavoidthedisadvantagesofmifepristoneadministration,andprovidasimpler,saferandmoreeffectivemicr-traumamethod.Keywords:radiofreguencyablation(RFCA);metrorrhagia;dysfunctionaluterinebleeding;mifepristone子宮功能性出血(DU