| Objective: Abnormal uterine bleeding(AUB),a complex and challenging disease which significantly affects the patients in the aspects of mental,psychological and quality of life,often occurs in the reproductive age and brings a lot of discomfort to the patients.Among all the treatments,the NovaSure impedance controlled endometrial ablation is mainly used in cases that medical treatment is unavailable and the patients have no fertility requirements,meanwhile,the procedure can be a less invasive alternative to hysterectomy.The aim of this paper was to investigate the clinical efficacy and adverse effects of NovaSure impedance controlled endometrial ablation on the treatment of AUB which heavy menstrual bleeding was the clinical manifestation and to evaluate its effectiveness and safety.Methods: Thirty-six patients with AUB who had undergone NovaSure impedance controlled endometrial ablation at Hebei General Hospital from early January 2015 to March 2016 was selected.All patients had no fertility requirements,and were excluded from the possibility of both pregnancy and endometrial malignant lesions.The PBLAC score of menstrual volume,VAS of dysmenorrheal degree and hemoglobin were observed and recorded before the operation,and all the above indexes were followed-up at 1 month,3 months,6 months and 12 months postoperatively,then be compared with the preoperative indexes respectively to evaluate the efficacy of the procedure.SPSS 17.0 was used to analyze all the data.The enumeration data was characterized by frequency and rate,and the measurement data,if the distribution was subject to normal,was described using(mean ± standard deviation),otherwise we utilized the median and quartile for the description.Taking ?=0.05 for the significance level,with P<0.05 for the difference was statistically significant.Results:1 Basic conditions:The procedure was successfully completed among the 36 patients.The depth we measured of the uterine cavity was 5.55±0.67 cm and the width was 4.17±0.26 cm.In the operation,with a duration of 90.53±13.91 s and a power of 110.69±16.22 w,the blood loss was 5.31±2.04 ml.2 The PBLAC score of menstrual flow: Before the operation,the score was 281.50(195.50,325.50),and after 1,3,6,12 months,the score was 0(0,14.75),0(0,8.75),0(0,9.00)and 0(0,7.75)respectively.The score in different follow-ups was significantly lower than that before the treatment and the difference was statistically significant(P<0.05).3 The VAS of dysmenorrhea degree: Of all the 36 patients,the VAS before the operation was 4(0,6.00),and the number of the patients who combined with dysmenorrhea was 21.Then the number of people who still with dysmenorrheal reduced to 12,8,6 and 5 respectively at 1 month,3 months,6 months,and 12 months after the operation.According to statistical analysis on the data attained,there was significant difference between the score preoperative and postoperative in each follow-up time(P<0.05).4 Hemoglobin: The mean value of preoperative hemoglobin was 89.25±19.33 g /L,and in 1 month,3 months,6 months and 12 months after the treatment,the average grew to 104.17±13.45g/L,117.72±11.30g/L,118.92±9.80g/L and 120.50±6.70g/L separately.The difference of the hemoglobin between each follow-up time and that preoperative was statistically significant(P<0.05).5 With an effective rate of 97.2%,the amenorrhea rate of 1 month,3 months,6 months and 12 months after NovaSure impedance controlled endometrial ablation was 58.3%,66.7%,66.7% and 69.4%.The satisfaction rate was 88.9%,91.7%,94.4%,94.4% and the satisfaction rate of sexual life was 75%,80.56%,91.67% and 91.67% respectively.Conclusions:The NovaSure impedance controlled endometrial ablation can not only reduce the menstrual volume,but also play an important role in relieving the degree of dysmenorrhea as well as correcting anaemia effectively,besides,it also shows a high sexual satisfaction rate.NovaSure,with great clinical value,is noted for its exact efficacy and great safety,and has the advantages of short operation time,no special preoperative treatment,easy to grasp for the operator and also available for the circumstance of a variety of medical complications. |
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