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1、射频治疗子宫功能性出血的疗效观察作者:戴良图,张华,许恒,唐大海单位:解放军第四一一医院妇产科,上海【摘要】目的:探讨射频治疗和口服米非司酮2种方法治疗功能失调性子宫出血(DUB)的临床疗效。方法:将207例经诊断性刮宫病理确诊为DUB的患者分成3组:射频组127例,用功率30~35W消融治疗;米非司酮组40例,给予连续口服小剂量米非司酮;对照组40例给予止血。定期检测3组患者的血红蛋白、子宫大小、卵巢性激素水平并随访疗效。结果:射频组和米非司酮组治疗对改善月经、纠正贫血均有效,且2组差异无统计学
2、意义(P>0.05)。米非司酮组用药后血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)和孕酮(P)的平均水平较用药前均有不同程度的下降,尤以E2、P下降更为明显(P<0.01),而射频组血清FSH、LH、E2、P的平均水平治疗前后差异无统计学意义(P>0.05)。结论:米非司酮和射频治疗DUB有效、安全、不良反应小,对原有合并症无影响。米非司酮具有服药简便、安全的优点,但同时具有影响内分泌功能、长期服药后耐药等缺点,射频治疗则能克服米非司酮治疗的不足,成为治疗DUB的
3、一种更为简便、安全、有效、微创的方法。【关键词】射频治疗;月经失调;子宫功能性出血;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子宫功能性出血(DU