自凝刀射频消融治疗2082例子宫肌瘤疗效及其影响因素分析  

A curative effect observation and its influencing factors analysis on radiofrequency ablation in the treatment of 2082 cases of uterine fibroids

作　　者：徐萍萍 肖梅 史佃云 

机构地区：[1]解放军81医院妇产科,江苏南京210002

出　　处：《东南国防医药》2016年第2期151-153,173,共4页Military Medical Journal of Southeast China

摘　　要：目的探讨自凝刀射频消融治疗子宫肌瘤的疗效及影响因素,以便预先采取相应处理,提高射频治疗子宫肌瘤的疗效。方法对2008年2月-2014年8月2082例子宫肌瘤患者行射频消融治疗的临床资料进行回顾性分析。筛选11项与疗效可能相关的因素,进行单因素及多因素分析,单因素分析采用Fisher确切概率法分析,多因素分析采用logistic回归分析。结果术后6个月和12个月的治愈率、显效率分别为42.8%、50.2%,和45.1%、51.8%。分析可能影响疗效的11项单因素中,黏膜下、肌壁间肌瘤7项有统计学意义,分别为:是否多发、位置、瘤体直径、是否突向浆膜下、射频次数、有无合并其他治疗和手术者经验;浆膜下4项有意义,分别为位置、瘤体大小,基底宽和射频次数。多因素黏膜下子宫肌瘤有3项,分别为:位置、瘤体直径和有无合并其他治疗;浆膜下肌瘤仅有突出位置。结论自凝刀射频消融治疗子宫肌瘤是安全、疗效较好的微创疗法,瘤体位置、直径、是否多发是疗效主要影响因素,选择合适的治疗对象,掌握治疗指征,规范操作和仪器专人管理能明显减少并发症的发生率。Objective To evaluate the clinical efficacy of the radiofrequency ablation in the treatment of uterine fibroids guided by CDFI and explore its risk factors after treatment,so as to provide the basis of further optimization of the treatment by taking corresponding processing in advance. Methods The clinical data of 2082 patients with uterine fibroids who were treated by radiofrequency ablation in our hospital from February 2008 to August 2014 were analyzed retrospectively. 11 possible related factors were screened and analysed by single factor and multiple factors analysis. Single factor analysis used Fisher exact probability method and multi-factor analysis used Logistic regression analysis. Results The cure rate of 6 months and 12 months after operation were 42. 8%and 50. 2% respectively,and efficiency were 45. 1%,51. 8% respectively. Submucosal and muscular fibroids of the 11 single influencing factors were statistically significant,including age,multiple,position,the diameter of tumors,break through the serous membrane layer,frequency,combination of other treatment; Submucosal uterine fibroids have three factors： location,the diameter of tumors,and the presence of merging other treatment; Subserosal fibroids only had outstanding direction. Conclusion Radiofrequency ablation is safe and effective of minimally invasive therapy. The major factors affecting the efficacy of radiofrequency ablation are： location,the diameter of tumors,multiple. Choose appropriate preoperative treatment object,reasonable treatment indications,standardized operation and equipment of personnel management can significantly reduce the incidence of complications.

关 键 词：子宫肌瘤 射频消融 疗效 

分 类 号：R737.33[医药卫生—肿瘤]