凉山地区子宫良性病变患者选择HIFU治疗的影响因素分析

Factors influencing the choice of HIFU for patients with uterine fibroids and adenomyosis in Liangshan areas

目的研究影响凉山地区子宫肌瘤及子宫腺肌病患者选择高强度聚焦超声(HIFU)治疗的相关因素。方法将凉山彝族自治州第一人民医院2017年12月至2019年6月收治的765例子宫肌瘤及子宫腺肌病患者根据治疗方式不同,分为HIFU组(n=263)与其他治疗组(n=502),比较两组年龄、民族、受教育程度、医疗付费方式、婚姻状态等资料,采用多因素logistic回归分析研究影响患者选择HIFU治疗的因素,并于治疗后6个月评价HIFU的治疗效果。结果单因素分析发现,年龄、民族、受教育程度、生育意愿及入院途径均是影响凉山地区子宫良性病变患者治疗方式选择的相关因素(P<0.05);logistic多因素回归分析显示,年龄小于或等于40岁、少数民族、大专及以上学历、具有生育意愿均是凉山地区子宫良性病变患者选择HIFU治疗的独立影响因素;HIFU治疗组术后6个月,病灶体积较术前缩小67.84%,子宫体积较术前缩小25.12%,临床总有效率为95.44%。结论凉山地区子宫良性病变患者选择HIFU治疗的影响因素有年龄、民族、学历、生育意愿等。

Objective To study the related factors influencing the clinical choice of high-intensity focused ultrasound(HIFU)treatment for patients with uterine fibroids and adenomyosis in Liangshan areas.Methods A total of 765 patients with uterine fibroids and adenomyosis admitted to the hospital from December 2017 to June 2018 in Liangshan areas were included in the study.According to the different treatment methods,they were divided into HIFU group(n=263)and other treatment group(n=502).The data of age,nationality,education level,medical payment method and marital status were compared between the two groups,and the factors affecting the choice of HIFU treatment was analyzed by multivariate logistic regression analysis,and the HIFU treatment effects were evaluated at 6 months after treatment.Results Univariate analysis found that age,nationality,education level,fertility willingness and admission route were related factors influencing the choice of treatment methods for patient with benign uterine lesions in Liangshan areas(P<0.05).logistic multivariate regression analysis indicated that age≤40 years old,minority,education level of junior college and above and fertility willingness were independent factors for HIFU choice of patients with uterine benign lesions in Liangshan areas.In HIFU group at 6 months after operation,the lesion volume was reduced by 67.84%compared with that before operation and the uterine volume was reduced by 25.12%compared with before operation,and the total clinical effective rate was up to 95.44%.Conclusion HIFU has goodefficacy in treating uterine fibroids and adenomyosis,and its choice is affected by age,ethnicity,education level and fertility willingness.