微波消融联合无水乙醇对子宫肌瘤患者内分泌状态及生育结局的影响

Effect of microwave ablation combined with absolute ethanol on endocrine status and reproductive outcomes in patients with uterine fibroids

目的探讨微波消融联合无水乙醇对子宫肌瘤患者内分泌状态及生育结局的影响。方法选取2014年1月—2017年3月于新疆医科大学第一附属医院接受治疗的102例子宫肌瘤患者,按随机数字表法分为对照组51例和观察组51例。对照组采用常规微波消融治疗,观察组则在微波消融基础上联合无水乙醇治疗,比较两组临床治疗效果、治疗前后雌二醇(E2)、孕激素(P)、黄体生成素(LH)以及卵泡刺激素(FSH)水平,同时观察两组生育结局和不良反应发生情况。结果观察组治疗后24 h、3个月的肌瘤完全消融率均高于对照组,差异有统计学意义(P<0.05)。两组治疗前3 d、治疗后3个月的E2、P、LH和FSH水平组间及组内比较差异均无统计学意义(P>0.05)。观察组的自然分娩率、新生儿Apgar评分和新生儿质量均高于对照组,差异有统计学意义(P<0.05)。两组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论微波消融联合无水乙醇治疗子宫肌瘤可以提高临床疗效,且可改善患者生育结局及内分泌状态,安全性较高,是治疗子宫肌瘤的一种有效方法,值得在临床广泛应用。

Objective To investigate the effect of microwave ablation combined with absolute ethanol on endocrine status and reproductive outcomes in patients with uterine fibroids.Methods One hundred and two patients with uterine fibroids treated in the First Affiliated Hospital of Xinjiang Medical University from January 2014 to March 2017 were divided into control group(51 cases)and observation group(51 cases)according to random number table method.Control group was treated with conventional microwave ablation,while observation group was treated with absolute ethanol on the basis of microwave ablation.The clinical effects,estradiol(E2),progesterone(P),luteinizing hormone(LH)and follicle stimulating hormone(FSH)levels before and after treatment were compared between two groups.At the same time,the birth outcomes and adverse reactions of two groups were observed.Results The complete ablation rate of myoma in observation group was higher than that in control group after treatment of 24 hours and three months,and the differences were statistically significant(P<0.05).There were no significant differences in E2,P,LH and FSH levels between groups and within groups in two groups three days before treatment and three months after treatment(P>0.05).The natural delivery rate,neonatal Apgar score and neonatal quality of observation group were higher than those of control group(P<0.05).There was no significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion Microwave ablation combined with absolute alcohol in the treatment of uterine fibroids can improve clinical efficacy,and can improve the patients′reproductive outcome and endocrine status,which is an effective method for the treatment of uterine fibroids,it is worth widely used in clinical.