子宫肌瘤微波消融术对患者血清CTGF、TSGF变化及复发影响因素

The changes of serum connective tissue growth factor and malignant tumor related substance group levels of the women with uterine fibroids after microwave ablation and the influence factor of recurrence

目的:研究子宫肌瘤微波消融术对患者血清结缔组织生长因子(CTGF)、恶性肿瘤相关物质群(TSGF)变化及预后影响因素。方法:回顾性收集2018年6月-2019年12月本院妇产科接收治疗的子宫肌瘤患者100例临床资料,根据手术方式分为微波消融术(观察组,54例)和腹腔镜子宫肌瘤剔除术(对照组,46例)。比较两组手术指标,手术前后血清CTGF、TSGF变化及并发症发生情况,分析术后子宫肌瘤复发影响因素。结果:观察组手术时间、出血量、排便时间、排气时间、肠鸣音时间等均小于对照组(P<0.05);术后观察组CTGF(223.64±31.57 ng/ml)、TSGF(53.49±4.65 U/ml)小于对照组(336.57±46.37 ng/ml、60.45±5.34 U/ml),并发症发生率观察组(3.7%)小于对照组(26.1%)(P<0.05)。术后子宫肌瘤复发情况与CTGF(r=0.621,P=0.000)、TSGF(r=0.327,P=0.001)呈正相关,且术前CTGF是影响术后肌瘤复发的独立危险因素。结论:采用微波消融术治疗子宫肌瘤效果优于腹腔镜手术,可缩短手术时间,减少并发症发生,术后血清CTGF、TSGF有所好转,其中CTGF是术后子宫肌瘤复发独立危险因素,临床应高度重视。

Objective:To study the changes of serum connective tissue growth factor(CTGF)and malignant tumor related substance group(MTRSG)levels of the women with uterine fibroids after microwave ablation,and to analyze the influence factor of prognosis of uterine fibroids.Methods:The clinical data of 100 women with uterine fibroids who had received treatment from June 2018 to December 2019 were collected retrospectively.These women were divided into observation group(54 cases were given microwave ablation of uterine fibroids)and control group(46 cases were given laparoscopic myomectomy)according to the different surgical methods.The surgical indexes,the changes of serum CTGF and TSGF before and after surgery,and the occurrence of complications of the women were compared between the two groups.The influencing factors of uterine fibroids recurrence after surgery were analyzed.Results:The operation time,the blood loss,the defecation time,the exhaust time,and the bowel sound time of the women in the observation group were significantly less than those of the women in the control group(P<0.05).The levels of CTGF(223.64±31.57 ng/ml)and MTRSG(53.49±4.65 U/ml)of the women in the observation group were significantly lower than those(336.57±46.37 ng/ml and 60.45±5.34 U/ml)of the women in the control group.The complication rate(3.7%)of the women in the observation group was significantly lower than that(26.1%)of the women in the control group(P<0.05).Postoperative fibroid recurrence was positively correlated with the CTGF level(r=0.621,P=0.000)and the MTRSG level(r=0.327,P=0.001).The preoperative CTGF level was an independent risk factor of postoperative fibroid recurrence.Conclusion:Microwave ablation for treating uterine fibroids of the women has better effect than that of laparoscopic myomectomy,which can shorten the operation time and can reduce the complications rate.The levels of postoperative serum CTGF and MTRSG will improve,and the level of CTGF is an independent risk factor for the recurrence of uterine fibroids,so it should be paid attention to in clinic.