高强度聚焦超声消融术与外科手术治疗剖宫产术后腹壁子宫内膜异位症的疗效比较  被引量:10

Comparison of High-intensity Focused Ultrasound Ablation and Surgical Treatment for Abdominal wall Endometriosis after Cesarean Section

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作  者:林振江[1] 袁利[1] 刘颂[1] 王馨 安强[1] 刘婷[1] 王东红 王娇 黄芹 陈大勇[1] 杨炳[1] LIN Zhenjiang;YUAN Li;LIU Song(Department of Obstetrics and Gynecology,the Affiliated Hospital of Zunyi Medical College,Zunyi Guizhou 563000,China)

机构地区:[1]遵义医学院附属医院妇产科,贵州遵义563000 [2]重庆医疗国家工程中心,重庆401121 [3]不详

出  处:《实用妇产科杂志》2020年第7期520-522,共3页Journal of Practical Obstetrics and Gynecology

基  金:贵州省科技计划项目(编号:201942940112230103)。

摘  要:目的:探讨高强度聚焦超声(HIFU)消融术和外科手术治疗剖宫产术后腹壁子宫内膜异位症(AWE)的疗效和预后。方法:对2016年5月至2017年8月在遵义医学院附属医院就诊的35例剖宫产术后AWE患者进行回顾性研究,16例患者接受HIFU消融术治疗(HIFU组),19例患者接受手术切除治疗(手术组)。对比两组患者的治疗结果和随访情况。结果:HIFU组与手术组在术中出血量(0 vs 79.32±28.17 ml)、术后当天疼痛评分(3.50±1.83分vs 5.42±2.24分)、住院天数(5.25±2.02天vs 8.37±3.80天)和住院花费(5388.56±883.81元vs 13262.07±1461.62元)差异均有统计学意义(P<0.05);HIFU组术中及术后主要副反应为治疗区胀痛5例和皮肤烧灼感8例,手术组术后主要副反应为切口疼痛19例、头痛2例、呕吐1例、尿潴留3例等。两组患者在为期1年的随访中均无复发。结论:HIFU消融和手术切除均能有效治疗剖宫产术后AWE,但是HIFU消融术创伤小、副反应少,降低了患者平均住院费用。Objective:To compare the efficacy and prognosis of high intensity focused ultrasound(HIFU)and surgical treatment for abdominal endometriosis(AWE)after cesarean section.Methods:A retrospective study was performed on 35 patients with AWE who underwent cesarean section from May 2016 to August 2017.A total of 16 patients underwent HIFU ablation(HIFU group)and 19 patients underwent surgical resection(surgical group).The outcomesof the follow-up were compared between the two groups of patients.Results:The intraoperative blood loss(0 vs 79.32±28.17 ml),postoperative pain score(3.50±1.83 score vs 5.42±2.24 score),length of hospital stay(5.25±2.02 d vs 8.37±3.80 d),and hospitalization cost(5388.56±883.81 yuan vs 13262.07±1461.62 yuan)were significantly lower in the HIFU group than in the surgical group.The difference was statistically significant(P<0.05).The main adverse reactions during and after HIFU ablation were pain(5/16)and skin burning sensation(8/16),while the main adverse reactions in the surgery group were incisional pain(19/19),headache(2/19),vomiting(1/19),urinary retention(3/19),etc.There was no recurrence in the two groups of patients during the one-year follow-up.Conclusions:HIFU ablation and surgical resection can effectively treat AWE after cesarean section.However,compared with traditional surgical methods,HIFU ablationis minimally invasive and significantly reduces the average hospitalization cost of patients.HIFU application should be promoted and extended in clinic.

关 键 词:高强度聚焦超声 子宫内膜异位症 剖宫产 

分 类 号:R711.71[医药卫生—妇产科学]

 

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