聚焦超声消融与肌瘤挖除术后子宫肌瘤患者盆腔粘连情况及影响因素的对比分析  

Comparative analysis of pelvic adhesion after focused ultrasound ablation and myomectomy in the treatment of uterine leiomyoma and its influencing factors

作　　者：陈林 刘晓芳[2] 牟燕[2] 何佳 CHEN Lin;LIU Xiaofang;MU Yan;HE Jia(Graduate School,Zunyi Medical University,Zunyi,Guizhou 563006,China;Department of Obstetrics and Gynecology,Suining Central Hospital,Suining,Sichuan 629000,China;Department of Obstetrics and Gynecology,Suining Municipal Hospital of Traditional Chinese Medicine,Suining,Sichuan 629000,China)

机构地区：[1]遵义医科大学研究生院,贵州遵义563006 [2]四川省遂宁市中心医院妇产科,629000 [3]四川省遂宁市中医院妇产科,629000

出　　处：《重庆医学》2022年第4期612-617,共6页Chongqing medicine

基　　金：四川省中医药管理局科学技术研究专项课题(2020LC0220)。

摘　　要：目的比较既往行子宫肌瘤挖除术与聚焦超声消融(focused ultrasound ablation,FUA)术的子宫肌瘤患者盆腔粘连情况,并分析影响盆腔粘连的因素。方法选取2014年1月至2020年10月遂宁市中心医院收治的既往行子宫肌瘤挖除术或FUA术并再次手术的282例子宫肌瘤患者,根据既往治疗方式分为既往手术组(n=79)与既往FUA组(n=203)。收集两组患者的再次手术记录,根据盆腔粘连评分规则对两组患者盆腔粘连情况进行统计分析,并采用单因素分析及logistic回归分析确定盆腔粘连的影响因素。结果既往手术组盆腔粘连发生率(62.0%vs.46.8%)、盆腔粘连严重程度均明显高于既往FUA组,差异均有统计学意义(P<0.05)。单因素分析表明,两组患者的年龄、人工流产次数、病灶最大径均与盆腔粘连的发生相关(P<0.05)。logistic回归分析表明,两组患者的人工流产次数、病灶最大径均是盆腔粘连的独立影响因素。结论与子宫肌瘤挖除术相比,FUA治疗子宫肌瘤术后盆腔粘连发生率更低,盆腔粘连严重程度更轻。Objective To compare the pelvic adhesions in patients with uterine leiomyoma who underwent myomectomy and focused ultrasound ablation(FUA),and to analyze the factors affecting pelvic adhesions.Methods A total of 282 patients with uterine leiomyoma who had undergone myomectomy or FUA and received re-operation were selected from Suining Central Hospital from January 2014 to October 2020.According to the previous treatment,the patients were divided into the previous operation group(n=79)and the previous FUA group(n=203).The re-operation records of the two groups were collected,the pelvic adhesions of the two groups were statistically analyzed according to the pelvic adhesion scoring rules,and the influencing factors of pelvic adhesions were determined by univariate analysis and logistic regression analysis.Results The incidence(62.0%vs.46.8%)and severity of pelvic adhesions in the previous operation group were higher than those in the previous FUA group,and there were statistically significant differences(P<0.05).Univariate analysis showed that the age,the number of induced abortions and the maximum diameter of lesions in the two groups were all correlated with the incidence of pelvic adhesions(P<0.05).Logistic regression analysis showed that the number of induced abortions and the maximum diameter of lesions in both groups were independent influencing factors of pelvic adhesions.Conclusion Compared with myomectomy,the incidence of pelvic adhesions after FUA treatment for uterine leiomyoma is lower,and the severity of pelvic adhesion is lighter.

关 键 词：聚焦超声消融 子宫肌瘤挖除术 盆腔粘连 影响因素 

分 类 号：R737.33[医药卫生—肿瘤]