超声引导下医用无水乙醇硬化治疗卵巢子宫内膜异位囊肿的临床疗效评价  

Evaluation of Clinical Efficacy in Treatment of Ovarian Endometriosis Cyst with Medical Absolute Ethanol Under Ultrasound-Guidance

作　　者：王博逸 黄品同[1] 黄斌 孙希希 洪勇强[2] 柴佳园 亓倩倩 Wang Boyi;Huang Pintong;Huang Bin;Sun Xixi;Hong Yongqiang;Chai Jiayuan;Qi Qianqian(Department of Ultrasound,The Second Affiliated Hospital Zhejiang University of Medicine,Hangzhou 310oo0,China;Department of Ultrasound,Zhejiang Hospital,Hangzhou 310000,China)

机构地区：[1]浙江大学医学院附属第二医院超声科,杭州市310000 [2]浙江医院超声科,杭州市310000

出　　处：《中国超声医学杂志》2024年第11期1284-1288,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的评价超声引导下医用无水乙醇硬化治疗卵巢子宫内膜异位囊肿(EC)的临床疗效。方法选取50例EC患者并行硬化治疗,根据不同硬化剂治疗分为两组,其中医用无水乙醇治疗为研究组24例,用聚桂醇治疗为对照组26例。研究组分为利多卡因组即A组14例(硬化前行利多卡因冲洗),非利多卡因组即B组10例(硬化前未行利多卡因冲洗),比较两组患者临床疗效、不良反应以及糖类抗原125(CA125)、糖类抗原153(CA153)、糖类抗原199(CA199)、卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、抗穆勒管激素(AMH)数值变化。结果术后3个月研究组有效率[100%(24/24)]比对照组[92.3%(24/26)]略高,但差异无统计学意义;研究组治愈率[83.3%(20/24)]比对照组[53.8%(14/26)]高,差异有统计学意义(P<0.05);两组术后临床症状均有明显改善,且研究组优于对照组,比较差异有统计学意义(P<0.05);术后3个月两组患者CA125指标均降低,与术前比较差异有统计学意义(P<0.05),其他指标均无统计学意义;研究组的CA125指标比对照组更低,差异有统计学意义(P<0.05)。研究组疼痛评分显著高于对照组(P<0.05),但利多卡因组(A组)疼痛评分有明显改善,且与对照组差异无统计学意义。结论超声引导下进行EC硬化治疗,聚桂醇与医用无水乙醇均保护卵巢功能,医用无水乙醇疗效更佳,改良后疼痛可控,具有较高的临床价值。Objective To evaluate the clinical efficacy of ultrasound-guided medical absolute ethanol sclerotherapy for ovarian endometriosis cyst(EC).Methods A total of 50 patients with EC were selected for sclerotherapy and divided into two groups based on different sclerosing agents.The study group consisted of 24 patients treated with medical absolute ethanol,while the control group comprised 26 patients treated with lauromacrogol.The study group was divided into lidocaine group A(14 cases)(lidocaine irrigation before hardening)and non-lidocaine group B(10 cases,no lidocaine irrigation before hardening).The clinical efficacy,adverse reactions,and changes in carbohydrate antigen 125(CA125),carbohydrate antigen 153(CA153),carbohydrate antigen 199(CA199),follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),and anti-Mullerian hormone(AMH)levels were compared among the groups.Results At 3 months post-surgery,the effective rate in the study group was 100%(24/24),slightly higher than the 92.3%(24/26)in the control group,but the difference was not statistically significant.The cure rate in the study group was 83.3%(20/24),significantly higher than the 53.8%(14/26)in the control group(P<0.05).Clinical symptoms improved significantly in both groups after operation,with the improvement being more pronounced in the study group(P<0.05).Three months after operation,CA125 levels decreased significantly in both groups compared to pre-operation levels(P<0.05),while no significant differences were observed in other markers.Notably,CA125 levels were lower in the study group compared to the control group,with a statistically significant difference(P<0.05).Pain scores were significantly higher in the study group(P<0.05),but in modified subgroup(group A)pain scores improved significantly and the difference were no longer significant to those in the control group.Conclusions Ultrasound-guided EC sclerotherapy with either lauromacrogol or medical absolute ethanol protects ovarian function.Medical absolute ethanol demonstrated

关 键 词：子宫内膜异位囊肿 硬化治疗 医用无水乙醇 聚桂醇 

分 类 号：R445.1[医药卫生—影像医学与核医学] R713[医药卫生—诊断学]