超声引导介入治疗卵巢子宫内膜异位囊肿的疗效评估  

Efficacy evaluation of ultrasound-guided interventional therapy for ovarian endometriotic cysts

作　　者：龚曌 刘明辉[1] GONG Zhao, LIU Minghui(Department of Ultrasound, the Second Xiangya Hospital of Central South University, Changsha 410000, Chin)

机构地区：[1]中南大学湘雅二医院超声科,湖南长沙410000

出　　处：《中国医学物理学杂志》2018年第3期292-295,共4页Chinese Journal of Medical Physics

基　　金：湖南省自然科学基金(12JJ3102)

摘　　要：目的:分析超声引导介入治疗卵巢子宫内膜异位囊肿的疗效。方法:选取2014年3月至2016年3月在湘雅二医院就诊的临床诊断为子宫内膜异位囊肿的143例患者,随机分为对照组和试验组。对照组71例,采用腹腔镜囊肿剔除术;试验组72例,采用超声介入穿刺治疗,用穿刺针抽空囊腔内的液体,然后生理盐水冲洗囊腔,根据囊肿大小注入无水乙醇,无水乙醇用量约为抽出囊腔内液体的70%,无水乙醇留置囊腔内10 min后抽出。治疗后6个月随访,了解患者症状改善、妊娠及复发情况,检测血清中黄体生成素、卵泡雌激素及超声检查窦状卵泡数的变化情况,评估两种方式对卵巢功能的影响。结果:对照组手术时间显著高于试验组[(60.24±5.33)min vs(42.13±3.17)min,P<0.05];试验组经过治疗,囊肿全部消失,对照组行腹腔镜手术后剔除囊肿65例,有6例患者合并有子宫肌瘤转开腹手术。对照组治疗后卵泡雌激素高于试验组[(19.54±3.62)U/L vs(15.27±3.36)U/L,P<0.05];试验组治愈率显著高于对照组(94%vs 66%,P<0.05);对照组复发率显著高于试验组(25%vs 9%,P<0.05)。结论:介入性超声治疗卵巢子宫内膜异位囊肿治愈率高,可有效减少复发,对卵巢损伤小,不影响生育功能,是一种操作简单安全有效的治疗方式。Objective To evaluate the clinical effect of ultrasound-guided interventional therapy for ovarian endometriotic cysts. Methods A total of 143 patients with clinically diagnosed ovarian endometriotic cysts treated in the Second Xiangya Hospital of Central South University between March 2014 and March 2016 were randomly divided into control group and experimental group. The 71 patients in control group were treated with laparoscopic cystectomy, while the 72 patients in experimental group received ultrasound interventional puncture. In experimental group, the fluid in the capsule cavity was aspirated with a puncture needle, and the capsule cavity was rinsed with normal saline. After rinsing, the ethanol was injected according to the cyst size. The amount of anhydrous ethanol was about 70% of the cavity fluid, and after 10 minutes of indwelling, the aspiration of anhydrous ethanol was performed. Six months after treatment, patients were followed-up for understanding the symptoms improvement, pregnancy and recurrence. The levels of luteinizing hormone and follicle estrogen in the serum, and the number of antecedullary follicles detected by ultrasound were measured to assess the effects of both modalities on ovarian functions. Results The operation time in control group was significantly higher than that in experimental group [ （60.24±5.33） min vs （42.13± 3.17） min, P〈0.05 ]. After the treatment, cysts were disappeared in experimental group. In control group, cysts were removed in 65 cases after receiving laparoscopic surgery, and laparotomy were performed for 6 patients with uterine fibroids. The follicular estrogen in control group was higher than that in experimental group [ （19.54±3.62） U/L vs （15.27±3.36） U/L, P〈0.05 ]. The cure rate of experimental group was 94%, significantly higher than 66% in control group （P〈0.05）. The recurrence rate of control and experimental groups were 25% and 9%, with significant differences （P〈0.05）. Conclusion Interventional ultrasound therapy is a

关 键 词：卵巢子宫内膜异位囊肿 介入性超声治疗 腹腔镜囊肿剔除术 

分 类 号：R711.71[医药卫生—妇产科学]