超声引导下高强度聚焦超声治疗子宫肌瘤疗效及对患者氧化应激和免疫功能影响

Efficacy of ultrasound guided high-intensity focused ultrasound for treating uterine fibroids of patients and its influence on their oxidative stress and immune function

目的:分析超声引导下高强度聚焦超声(HIFU)治疗子宫肌瘤疗效及其对患者氧化应激和免疫功能的影响.方法:选取2019年1月—2021年1月本院收治的90例子宫肌瘤患者,根据手术方式不同分为腹腔镜下子宫肌瘤剔除术的腹腔镜组40例和超声引导高强度聚焦超声的HIFU组50例.比较两组围术期指标、临床效果及治疗前后氧化应激、免疫功能指标.结果:HIFU组与腹腔镜组手术时间(64.5±14.2min比88.1±16.3min)、术中出血量(0ml比110.2±14.2ml)、住院时间(1.9±0.6d比4.3±0.9d)及术后1d时VAS评分(2.1±0.4分比4.4±0.8分)均差异(P<0.05),治疗有效率HIFU组(92.0%)与腹腔镜组(95.0%)无差异(P<0.05).治疗后两组血清丙二醛(MDA)、活性氧(ROS)、晚期氧化蛋白产物(AOPP)水平均高于治疗前,超氧化物歧化酶(SOD)低于治疗前,但HIFU组变化幅度小于腹腔镜组,两组血浆Th1/Th2、CD3、CD4、CD4/CD8水平均低于治疗前,CD8水平高于治疗前,但HIFU组变化幅度小于腹腔镜组(均P<0.05).结论:两种术式治疗效果相当,但超声引导HIFU治疗子宫肌瘤对患者氧化应激和免疫功能影响更小,患者术后恢复及预后更佳.

Objective: To analyze the efficacy of high intensity focused ultrasound(HIFU) guided by ultrasound for treating uterine fibroids of patients, and to study its influence on the oxidative stress and immune function of the patients. Methods: A total of 90 patients with uterine fibroids were selected as the research subjects from January 2019 to January 2021. According to the different surgical methods, these patients were divided into control group(40 cases with treatment by laparoscopic myomectomy) and study group(50 cases with treatment by HIFU). The perioperative indicators, clinical effect, and oxidative stress and immune function indicators before and after treatment of the patients were compared between the two groups. Results: There were significant differences in the operative time(64.5±14.2 min vs. 88.1±16.3 min), the intraoperative blood loss(0 ml vs. 110.2±14.2 ml), the time of hospital stay(1.9±0.6 d vs. 4.3±0.9 d), and the VAS scores in the 1 st day after surgery(2.1±0.4 vs. 4.4±0.8) of the patients between the two groups(P<0.05), but there was no significant difference in the effective rate of treatment(92.0% vs. 95.0%) of the patients between the two groups(P>0.05). The levels of serum malondialdehyde(MDA), reactive oxygen species(ROS), and advanced oxide protein product(AOPP) of the patients in the two groups after treatment had increased significantly, and the superoxide dismutase(SOD) level of the patients in the two groups after treatment had decreased significantly, and the change range of which of the patients in the study group was significantly less than that of the patients in the control group. The levels of plasma Th1/Th2, CD3, CD4, and CD4/CD8 of the patients in the two groups after treatment had decreased significantly, and the CD8 level of the patients in the two groups after treatment had increased significantly,and the change range of which of the patients in the study group was significantly less than that of the patients in the control group(all P<0.05).Conclusion:The effect of the two surgical treatments for the patients with uterine fibroids is similar,but the effect of ultrasound-guided HIFU treatment has less adverse effects on the oxidative stress and the immune function of the patients,with better postoperative recovery and prognosis.