腹腔镜联合超声引导微波消融治疗子宫腺肌病对子宫血流超声参数及卵巢的影响  

Investigation of the effect of laparoscopic combined with ultrasound-guided microwave ablation on uterine blood flow ultrasound parameters and ovary in the treatment of adenomyosis

作　　者：吴丽萍[1] 初晓凌 徐静[1] 孙英姿 WU Liping;CHU Xiaoling;XU Jing;SUN Yingzi(Department of Ultrasound,Shandong Provincial Third Hospital,Jinan 250031,China)

机构地区：[1]山东大学附属省立第三医院超声科,山东济南250031

出　　处：《医学影像学杂志》2023年第7期1220-1222,1235,共4页Journal of Medical Imaging

摘　　要：目的探讨腹腔镜联合超声引导微波消融治疗子宫腺肌病对子宫血流及卵巢的影响。方法选取子宫腺肌病患者资料106例进行分析,患者均给予腹腔镜联合超声引导微波消融治疗。用彩色多普勒超声测量子宫动脉收缩期血流速度峰值(PSV)、舒张期末血流速度(EDV)、动脉搏动指数(PI)及阻力指数(RI)、子宫体积。对比子宫血流超声参数在微波消融前后的变化,对比分析与子宫腺肌病疗效的相关性。比较治疗前后雌二醇(E2)、促卵泡激素(FSH)、催乳素(PRL)和CA125水平,观察对卵巢的影响。结果子宫动脉血流量以及PI与微波消融后子宫腺肌病疗效呈负相关,RI与微波消融子宫腺肌病疗效呈正相关。消融前和随访中E2和FSH水平差异无统计学意义(P>0.05),血清CA125和PRL的平均绝对值均显著降低(P<0.001)。结论超声引导的微波消融术后子宫动脉血流量及PI明显降低,RI升高,对患者病情预后情况有一定帮助,消融术后未观察到卵巢功能下降的证据。Objective To study the effect of laparoscopy combined with ultrasound-guided microwave ablation on uterine blood flow and ovary in the treatment of adenomyosis.Methods Atotal of 106 patients with adenomyosis were selected as the research objects.All patients were treated with laparoscopic combined with ultrasound-guided microwave ablation.The uterine artery peak systolic velocity(PSV),end-diastolic velocity(EDV),arterial pulsatility index(PI),resistance index(RI)and uterine volume were measured by color Doppler ultrasound.We compared the changes of uterine blood flow ultrasound parameters before and after microwave ablation,and studied the correlation with the efficacy of adenomyosis.The levels of estradiol(E2),follicle stimulating hormone(FSH),prolactin(PRL)and CA125 before and after treatment were compared to observe the effect on the ovary.Results The uterine arterial blood flow and PI were negatively correlated with the efficacy of microwave ablation of adenomyosis,and RI was positively correlated with the efficacy of microwave ablation of adenomyosis.There was no significant difference in E2 and FSH levels between pre-ablation and follow-up(P>0.05),but the mean absolute values of serum CA125 and PRL were significantly decreased(P<0.001).Conclusion After ultrasound-guided microwave ablation,the uterine artery blood flow and PI are significantly decreased,and RI is increased,which is helpful for the prognosis of patients.Both serum CA125 and PRL levels are significantly decreased after treatment.No evidence of decreased ovarian function is observed after ablation.

关 键 词：子宫动脉血流参数 高强度聚焦超声消融 子宫腺肌病 超声检查 

分 类 号：R711.74[医药卫生—妇产科学] R445.1[医药卫生—临床医学]