聚焦超声治疗583例外阴上皮内非瘤样病变的临床疗效分析

Clinical effect of focused ultrasound on the treatment of nonneoplastic epithelial disorders of vulva: a retrospective study of 583 cases

目的观察聚焦超声治疗外阴上皮内非瘤样病变的近远期疗效,并分析影响疗效的相关因素。方法收集2004年1月-2014年6月在重庆医科大学附属第二医院接受聚焦超声治疗的外阴上皮内非瘤样病变且具有完整随访资料的患者583例,回顾性分析其疗效、并发症及其相关影响因素。结果聚焦超声治疗外阴上皮内非瘤样病变总有效率为97.43%,复发率28.65%,并发症发生率9.09%。其疗效与患者是否接受再次巩固治疗有关,接受巩固治疗的患者其有效率明显上升(P<0.05);并发症的发生与治疗方式有关,使用CZF300机型高功率短时间治疗者并发症发生率明显高于使用CZF-1机型低功率长时间治疗者(P<0.001)。结论聚焦超声治疗外阴上皮内非瘤样病变疗效可靠,采用多次巩固治疗及低功率长时间治疗方案可提高疗效,降低并发症发生率。

Objective To evaluate the short and long-term effect and explore the potential influential factors of focused ultrasound in the treatment of nonneoplastic epithelial disorders of vulva（NNEDV）. Methods Clinical data of 583 patients suffering from NNEDV which was treated with focused ultrasound admitted from Jan. 2004 to Jun. 2014 to the hospital the authors ser ved were collected. The treatment effects, complication rate, and potential influential factors were retrospectively analyzed. Results The total effective rate of focused ultrasound in treating NNEDV was 97.43%, the recurrence rate was 28.65%, and the complication rate was 9.09%. The effective rate was significantly increased after a course of strengthened treatment（P〈0.05）. The incidence of complications of CZF300（high-power and short term model） treatment was significantly higher than that with CZF-1（low-power and long term model, P〈0.001）. Conclusions A good clinical effect is predictable with focused ultrasound in the treatment of NNEDV. More promising results could be attained with multiple strengthened treatment, and a lower complication rate can be obtained with a low-power and long term treatment strategy.