经腹超声引导与腹腔镜下射频治疗子宫肌瘤的对比分析

A contrastive analysis: suprapubic sonographically guided trancervical radio frequency ablation and laparoscope guided radio frequency ablation on hysteromyoma

目的 探讨经腹超声与经腹腔镜引导下射频消融治疗子宫肌瘤的优缺点。方法 选择135例症状性子宫肌瘤患者,其中86例子宫肌瘤患者经腹超声引导下经阴道行射频消融治疗（SSG组）,49例经腹腔镜引导下行射频消融治疗（TG组）＂,长海痛尺＂评估术后疼痛,术后第6个月随访,分别观察其疗效和并发症。结果两者总有效率分别为91.9%和95.9%,差异无显著性;SSG组术后3 h疼痛评分明显低于TG组,差异有显著性;对于肌瘤直径4～6 cm,肌瘤数量≥3个的患者,TG组疗效显著优于SSG组。结论 经腹超声与经腹腔镜引导下射频消融治疗子宫肌瘤疗效确切,同时经腹部超声引导经阴道治疗子宫肌瘤具有损伤小,住院时间短,术后疼痛轻等优点,但对于肌瘤直径〉4 cm,肌瘤数量≥3个的患者,效果欠佳,必要时选用经腹腔镜引导下的射频治疗。

[ Objective ] To detect the merits or shortage of suprapubic sonographically guided trancervical radio frequency ablation and lapamscope guided radio frequency ablation on hysteromyoma. [ Methods ] 135 women bearing symptomatic intramural uterine myomas. 86 cases were under process of transcervical radio frequency thermal ablation with suprapubic sonographic guidance （SSG group）. The others, 49 women were performed the laparoseope guided radio frequency ablation （TG group）. Measurement of reduction in the volumes of myomas was scheduled at 6 months after operation. The pain after operation was soon evaluated by a rating scales ＂Changhai pain rules＂. The curative effect and complication were observed. [ Results ] 6 months after radio frequency ablation, the total effective rate was 91.9%, 95.9% respectively, SSG group showed slight post operational pain with significant deviation. While TG group＇s cure rate was more excellent than SSG group, on the ablation of patient with multiple hystermyoma or tumor huger than 4 cm in diameter. [Conclusion] Both of the two manners show the merits of effective, micro-traumatic, shot time in ward and safe, especially the SSG. While to the patient with multiple hystermyoma or tumor huger than 4 em in diameter, laparoscope guided radio frequency ablation will be judicious.