射频消融术治疗子宫腺肌瘤的实用价值分析

Practical value of radiofrequency ablation for the treatment of adenomyoma

目的观察射频消融术治疗子宫腺肌瘤的临床疗效及医疗费用,探讨其临床实用价值。方法回顾分析842例子宫腺肌瘤患者,分别经射频消融术、经腹腺肌瘤切除术及腹腔镜下腺肌瘤切除术治疗,记录术前腺肌瘤体积、痛经程度、月经血量、术中出血量、手术时间、术后抗生素使用时间、住院时间、住院费用等;术后半年复诊同时复查阴道超声,记录术后腺肌瘤体积、痛经程度、月经血量。结果总有效率射频消融组与经腹手术组及腹腔镜组相比较,其差别均无显著性(x^2值分别为0.368和0.342,均P>0.05);但射频消融组的术中出血、手术时间、术后抗生素使用时间、住院时间及住院费用明显减少,与经腹手术组相比:t值分别为75.801、35.922、43.737、283.496和218.955,均P<0.05;与腹腔镜纽相比:t值分别为115.162、16.236、30.210、167.036和238.845,均P<0.05。结论射频消融术在治疗子宫腺肌瘤过程中疗效好、创伤小,花费低,是一种临床实用性很高的新型微创技术。

Objective To observe the clinical efficacy and cost of radiofrequency ablation for the treatment of adenomyoma and to explore its practical value. Methods A retrospective analysis was carried out on 842 cases of uterine adenomyoma who were treated with radiofrequency ablation, abdominal adenomyoma resection or adenomyoma resection by laparoscopy. The volume of adenomyoma, degree of dysmenorrheal, blood loss of menstruation, blood loss during operation, time of operation, antibiotics administration after operative, length of stay, hospitalization cost were recorded. Half a year later, transvaginal ultrasound was carried out again and the volume of adenomyoma, degree of dysmenorrheal and blood loss of menstruation were recorded again in return visit. Results There was no statistical significant difference in total effective rate between radiofrequeney ablation group and other two groups（x2 value was 0. 368 and 0. 342, respectively, both P 〉 0.05 ）. However, blood loss during operation, operation time, antibiotics administration after operation, length of stay and hospitalization cost were significantly less in radiofrequeney ablation group than those of abdominal adenomyoma resection group（ t value was 75. 801, 35. 922, 43. 737, 283. 496 and 218. 955, respectively, all P 〈 0.05 ） and those of adenomyoma resection by laparoseopy group （t value was 115. 162, 16. 236, 30. 210, 167. 036 and 238. 845, respectively, all P 〈 0.05 ）. Conclusion Radiofrequency ablation in uterine adenomyoma is not only effective, less invasive, but also less expensive. It is a new minimally invasive technique with high clinical practical value.