高强度聚焦超声联合无水乙醇治疗子宫肌瘤的效果及对患者生殖激素水平的影响

Effect of HIFU combined with PEI in the treatment of uterine myoma and its effect on the level of reproductive hormones of patients

目的:探讨高强度聚焦超声(HIFU)联合无水乙醇(PEI)对子宫肌瘤患者的临床治疗效果及生殖激素水平的影响。方法:选取在医院实施手术治疗的140例绝经前子宫肌瘤患者,根据手术方法的不同将其分为观察组和对照组,每组70例。观察组采用HIFU联合PEI治疗,对照组采用腹式筋膜内子宫切除术,对比两组术后不同时间的血清雌激素(E2)、卵泡生成素(FSH)以及黄体生成素(LH)水平,并记录和对比观察组患者术前、术后1个月、3个月及6个月的子宫体积和肌瘤体积的变化。结果:观察组患者在术后1个月、3个月及6个月子宫肌瘤体积较术前明显的缩小、子宫肌瘤体积缩小率增大,差异均具有统计学意义(F=21.904,F=32.098;P<0.05);子宫体积较术前明显的缩小、子宫体积缩小率增大,差异有统计学意义(F=35.842,F=38.764;P<0.05)。术前两组患者的血清E2、FSH及LH水平比较,差异均无统计学意义(t=-0.358,t=-0.451,t=1.079;P>0.05);术后6个月,对照组患者的血清E2较术前显著降低,FSH和LH水平较术前显著的升高,观察组患者的血清E2高于对照组,FSH和LH水平低于对照组,两组比较差异有统计学意义(t=13.141,t=-13.056,t=-13.187;P<0.05)。结论:HIFU联合PEI治疗子宫肌瘤效果可靠,能有效减小肌瘤体积,同时对未绝经妇女的生殖激素水平影响小。

Objective To investigate the effect of high intensity focused ultrasound （HIFU） combined with percutaneous ethanol injection （PEI） on the clinical therapeutic effect and the reproductive hormones level of the patients with uterine myoma. Methods： 140 patients with premenopause uterine myoma were divided into observation group （70 cases） and control group （70 cases） according to surgical methods. Patients of observation group received the treatment that HIFU combined with PEI, and ones of control group received abdominal intrafascial hysterectomy. And E2, FSH and LH postoperative different time points between the two groups were compared, and the changes of uterine volume and myoma volume preoperation, and 1 month, 3 months, and 6 months post operation were recorded and further compared. Results： The uterine myoma volumes of 1 month, 3 months and 6 months postoperation of observation group were significantly reduced compared with control group, and minification rates of uterine myoma volume of them were significantly increased （F=21.904, F=32.098, P〈0.05）. And the uterine volumes of 1mo, 3mo and 6 mo post operation of observation group were significantly reduced than that of control group, and minification rate of uterine volumes of them were significantly increased （F=35.842, F=38.764, P〈0.05）. The differences of serum E2, FSH and LH between the two group were no significant （t=-0.358, t=-0.451, t=1.079, P〉0.05）. At 6 months post operation, the serum E2 of observation group was significantly decreased compared with preoperative E2, and FSH and LH level were significantly increased compared with preoperative them, respectively, and the serum E2 of observation group was significantly higher than that of control group, while the FSH and LH level of observation group were significantly lower than those of control group （t=13.141, t=-13.056, t=-13.187, P〈0.05）. Conclusion： The effect of HIFU combined with PEI in the treatment for uterine myoma is reliable, and it can effectively reduce the volume of myoma, at the same time, this method has little effect on the level of reproductive hormone of women who have not been menopause.