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目的探讨宫腔镜子宫内膜电切术治疗围绝经期功能失调性子宫出血的效果。方法选取66例反复药物治疗无效的围绝经期功能失调性子宫出血患者,采用宫腔镜子宫内膜电切术(transcervical resection of endometrium,TCRE)治疗,术后随访12个月,观察治疗效果。结果 66例均顺利完成手术,无并发症发生。术后12个月,闭经56例(84.85%),点状出血及月经少7例(10.61%),有效率95.45%,术后3个月后血红蛋白明显回升(P<0.05),子宫内膜变薄,回声不均,妇科内分泌检验指标促卵泡激素(FSH)、促黄体素(LH)、雌二醇(E2)、催乳素(PRL)、孕酮(P)及睾酮(T)水平的变化情况与术前差异无统计学意义(P>0.05)。结论 TCRE治疗围绝经期功血具有创伤小、并发症少、保留子宫、不影响卵巢内分泌功能等优点,安全有效,值得临床推广。
Objective To investigate the effect of hysteroscopic endometrial resection for dysfunctional uterine bleeding in perimenopausal period. Methods Sixty-six patients with dysfunctional uterine bleeding during peri-menopausal period were treated with repeated medication. The patients were treated with transcervical resection of endometrium (TCRE). The patients were followed up for 12 months to observe the therapeutic effect. Results 66 cases were successfully completed surgery without complications. In the 12 months after operation, 56 cases (84.85%) had amenorrhea, 7 cases (10.61%) had punctate bleeding and less menstruation, the effective rate was 95.45%. After 3 months, the hemoglobin increased significantly (P <0.05) Thinning, echoes, gynecological endocrine test indicators FSH, LH, E2, PRL, P and T There was no significant difference between preoperative and postoperative changes (P> 0.05). Conclusions TCRE has the advantages of less trauma, fewer complications, keeping the uterus, not affecting the ovarian endocrine function, and is safe and effective in the treatment of perimenopausal dysfunctional uterine bleeding. It is worthy of clinical promotion.