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目的:探讨影响微波子宫内膜去除术治疗月经过多预后的因素。方法:选择因月经过多药物治疗无效而行微波子宫内膜去除术(MEA)治疗患者共334例。术后随访患者的月经状况、手术疗效及术后症状复发再次干预治疗情况,术后平均随访时间64.7个月(3-115个月)。结果:MEA治疗月经改善总有效率为91.3%(305/334),其中闭经率为49.7%(166/334),月经量减少为41.6%(139/334);术后痛经改善的有效率为71.1%(140/197);患者对手术的满意率为91.9%(307/334);术后因症状复发等行再次干预治疗42例(12.6%,42/334),其中行二次MEA9例,子宫切除33例。结论:MEA治疗月经过多安全、有效。对子宫内膜的不完全破坏导致宫角残留岛状子宫内膜是术后复发的重要原因。年龄、合并子宫腺肌症是影响MEA手术远期成功率的主要因素。
Objective: To investigate the factors influencing the prognosis of menorrhagia after microwave endometrial ablation. Methods: A total of 334 patients undergoing microwave endometrial ablation (MEA) were selected for treatment of menorrhagia. Postoperative follow-up of patients with menstrual status, surgical efficacy and recurrence of postoperative recurrence of symptoms, postoperative average follow-up time 64.7 months (3-115 months). Results: The total effective rate of MEA treatment for menstruation was 91.3% (305/334). The rate of amenorrhea was 49.7% (166/334) and the decrease of menstrual flow was 41.6% (139/334). The effective rate of postoperative menstrual dysfunction was 71.1% (140/197). The satisfaction rate of the patients to the operation was 91.9% (307/334). After the operation, 42 patients (12.6%, 42/344) , Hysterectomy in 33 cases. Conclusion: MEA treatment of menorrhagia is safe and effective. Incomplete destruction of the endometrium leading to palace horn residual island-like endometrium is an important cause of postoperative recurrence. Age, combined with adenomyosis is the main factor affecting the long-term success rate of MEA surgery.