聚焦超声治疗对伴有慢性宫颈炎的不孕患者宫颈局部微环境的影响  

Improvement of cervical microenvironment after treatment of chronic cervicitis with focused ultrasound in infertility women

作　　者：林珍云[1] 徐键[1] 王惠云[1] 陆美红[1] 

机构地区：[1]浙江大学医学院附属妇产科医院生殖内分泌科浙江省女性生殖健康重点实验室,浙江杭州310006

出　　处：《浙江大学学报（医学版）》2007年第5期454-457,共4页Journal of Zhejiang University(Medical Sciences)

摘　　要：目的：探讨患慢性宫颈炎的不孕症患者聚焦超声（focused ultrasound，FUS）治疗后宫颈局部微环境的变化及其对受孕的潜在影响。方法：收集2005年7月～8月在浙江大学医学院附属妇产科医院不孕夫妇专科门诊就诊的中、重度宫颈糜烂不孕女性共10例。其中输卵管性不孕6例，子宫内膜异位症伴不孕2例，原因不明不孕2例。年龄25～34岁，月经周期规则，排卵正常；男方精液检查正常。择期用FUS治疗其宫颈糜烂，治疗后随访3个月。通过比较治疗前、后宫颈糜烂面变化、宫颈黏液评分和性交后试验结果，评价FUS对慢性宫颈炎的疗效及对宫颈局部微环境的影响。结果：10例患者经FUS治疗，治愈4例，显效4例，有效2例；所有患者在治疗期间未见明显并发症。治疗后中位宫颈黏液评分由11分提高到13分（wilcoxon检验，P=0．014），性交后试验发现宫颈黏液内中位活动精子数由22个提高到52个（wilcoxon检验，P=0．015）。1例不明原因不孕者在治疗2个月后临床妊娠。结论：FUS治疗慢性宫颈炎疗效确切，副反应少，能明显改善宫颈炎患者宫颈黏液的性状，提高精子在宫颈黏液中的穿透性，可能有助于受孕。Objective： To investigate the effects of focused ultrasound （FUS） treatment on cervical microenvironment in infertility women with chronic cervicitis. Methods： A total of 10 women treated in Infertility Clinic of Obstetrics and Gynecology Hospital of College of Medicine of Zhejiang University were assessed. The women aged from 25 to 34 with normal menstrual cycles had moderate or severe cervical erosion. Ultrasound showed they had normal ovulation. The sperms of their husbands had normal motility and number. The FUS they received had a focal depth range of 4-6 mm,a resonant frequency of 9-11 MHz,and an output power of 3.5 W. The follow-up time was three months. The changes of cervical mucus and the results of postcoital test were evaluated. The clinical effects on cervical erosion and complications were also evaluated. Results： In 6 cases of severe cervical erosion, 2 were cured, 2 were improved significantly （more than 50% reduction of erosion area） and 2 were improved （less than 50% reduction of erosion area）. In 4 cases of moderate cervical erosion, 2 were cured, 2 were improved significantly. After the treatment,the median of cervical mucus score during LH peak were increased from 11 to 13 （Wilcoxon test,P=0. 014）. Postcoital test showed that the median of highly motile sperm （grade Ⅲ and grade Ⅱ ） of 5 high-power field were increased from 22 to 52 （Wilcoxon test,P=0. 015）. Mild side effects without medical intervention included vaginal fluid in all 10 women, vaginal spotting in 2 women. No serious side effects were observed. Conclusion： The focused ultrasound therapy can help to improve the cervical microenvironment for infertility women with moderate or severe cervical erosion without serious side effects.

关 键 词：宫颈炎/治疗 不育 女(雌)性 宫颈黏液 性交 超声 高强聚焦 

分 类 号：R711.3[医药卫生—妇产科学] R711.6[医药卫生—临床医学]