| Abnormal uterine bleeding, is one of the most commongynecological diseases，can occur in menarche to menopausal women ofany age，Including the regulation of reproductive endocrine functiondisorders caused by dysfunction of blood or the reproductive system andimplement qualitative sex pathological change of uterine bleeding ofuterine bleeding in two categories. The etiology is complex and easy torepeated attacks，clinical on endometrial polyps，uterine fibroids，endometrial cancer and other common. The normal menstrual cycle for24-35days, menstrual period lasts about2-7days, the amount of20-60ml.While the abnormal uterine bleeding clinical manifestations of menstrualcycle disorder and uterine bleeding quantity and nature of the change, forexample: polymenorrhea, menorrhagia, irregular uterine bleeding andirregular uterine bleeding, excessive, The need for diagnostic tests beforetreatment, mainly with diagnostic curettage, hysteroscopy. Treatmentincludes medical treatment and operation treatment method in clinicalpractice, Drug therapy is the first line of treatment for uterine bleeding,But for the poor efficacy of drug therapy or inappropriate medication, andno fertility requirements of patients, especially in older patients are noteasy to follow, is more focused on operation treatment, includingtraditional hysterectomy and resection of the endometrium.Nova sure-impedance controlled endometrial ablation, belongs tothe second generation of endometrial resection was carried out in2001, the first in the USA. The mechanism of action: the impedance controlprinciple, using radiofrequency endometrial vaporization, when theimpedance control is increased to50, heating and drying of radiofrequency energy of endometrial tissue， when the drying degree reachesa predetermined value and tissue ablation depth optimal，tissue resistanceand contact resistance equipment makes the controller to stop the energytransmission， ablation depth more than shallow muscle layerautomatically stop operation，equipment automatically stop operationbelongs to blind exercises，so must be of diagnostic tests to rule outorganic disease of the surgical operation. Combining domestic andforeign literatures and this study， abdominal pain，after the operation，the amenorrhea rate and patient satisfaction rate of view are better thanother endometrial resectionObjectiveTo investigate the efficacy and clinical significance of Nova Suresystem for abnormal uterine bleeding control.Materials and MethodsFrom November2011to september2013，50women with abnormaluterine bleeding who were admitted into the first hospital of jilinuniversity that received Nova Sure system for treatment，among puredysfunctional uterine bleeding which26patients (mild anemia nine cases,six cases of moderate anemia, severe anemia, one case). Organic diseasecaused by bleeding in24cases, of which18cases of anemia (mildanemia in3cases,12cases of moderate anemia, severe anemia3cases),24patients blood diseases in12cases (4cases of leukemia, aplasticanemia3cases,2cases of thrombocytopenia, MDS1case, SLE1case,pancytopenia1case), renal failure (uremia)6cases,2cases of hypertension,1case of diabetes, heart disease one case, brain embolismin1case,1case of subarachnoid hemorrhage.) The clinical effect andcomplications were followed up．Operation MethodsThe Impedance control endometrial ablation from the HLJ companyin America.Inclusion criteria:(1) Menorrhagia and who have no fertility requirements；(2) Due to their own medical therapy or with severe medical illnessin patients who can not tolerate surgery；(3) there is evidence and require surgical patients retained theuterus；(4) The systemic examination and pathological results to eliminatethe reproductive system’s Organic disease；(5) The depth of uterine cavity is from4cm to10cm.Exclusion criteria:(1) Pregnancy or have the fertility requirements；(2) Lower uterine segment muscle wall is weak；(3) combined with abnormal uterine bleeding in patients withadenomyosis；(4) cervical dysplasia；(5) uterine abnormalities, such as uterine horns of the uterus or themediastinum；(6)Uterine cavity depth less than4cm or more than10cm, or widthless than2.5cm；(7) Patients with endometrial carcinoma or pre-cancerous；(8) Within the IUD in the cavity； (9) Patients with acute pelvic；(10) The acute genital or urinary tract infection.Statistics analysis:ResultsThe procedures was completed successfully in all the50patientswho were accepted the NovaSure’s treatment．The operation time was(ranged from78to120s)．During the operation，the blood loss was lessthan10ml.50patients, seven were lost in the follow-up of43patients,follow-up, according to statistics, after amenorrhea rate of76.7%(33/43);lower abdominal pain, fall18.6%. No intra-operative complicationsoccurred, while one case of complications occurred after one weekfollow-up.Conclusion1.Nova Sure—impedance controlled endometrial ablation for thetreatment of serious medical illness uterine bleeding (caused by organicdisease of abnormal uterine bleeding) due to clinically effective method.2.Nova Sure—Impedance controlled endometrial ablation, safer, afteramenorrhea rate. |
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