乙醇硬化治疗卵巢子宫内膜异位囊肿疗效的影响因素分析

Analysis of influencing factors on the efficacy of ethanol sclerotherapy for ovarian endometriotic cysts

目的:探讨超声引导下乙醇硬化治疗卵巢子宫内膜异位囊肿疗效的影响因素。方法:对2016年9月—2021年6月在中国医科大学附属盛京医院行超声引导下硬化治疗卵巢子宫内膜异位囊肿的167人次进行评估,随访6月。分析囊肿分隔的存在、病灶数量、穿刺针进针路径、穿刺针直径、乙醇浓度对囊肿体积缩小率的影响。结果:术后1月结果显示单发病灶的体积缩小率大于多发病灶((96.64±8.33)%vs.(90.69±15.08)%,P<0.05),术后3月单发病灶体积缩小率大于多发病灶((96.62±10.85)%vs.(88.79±20.23)%,P<0.05),无分隔囊肿体积缩小率大于有分隔囊肿((96.61±8.66)%vs.(88.49±21.65)%,P<0.05),术后6月结果显示使用浓度75%的酒精治疗囊肿的疗效并不弱于使用浓度95%的酒精治疗的疗效((97.99±4.92)%vs.(90.97±30.91)%,P<0.05),使用17G穿刺针囊肿体积缩小率大于使用18G((97.46±6.70)%vs.(80.98±40.75)%,P<0.05)。结论:超声引导下乙醇硬化治疗卵巢子宫内膜异位囊肿的疗效显著,同时该治疗方法安全、微创。对于使用17G穿刺针,浓度75%的医用酒精,病灶单发及囊肿无分隔的患者,治疗后可以取得较满意疗效。

Objective:To investigate the factors affecting the curative effect of ultrasound-guided ethanol sclerotherapy for ovarian endometriotic cysts(OEC).Methods:From September 2016 to June 2021,one hundred and sixty-seven patients who underwent ultrasound-guided sclerotherapy for OEC in Shengjing Hospital of China Medical University were evaluated and followed up for 6 months.The effects of the presence of cyst separation,the number of lesions,the path of the puncture needle,the diameter of the puncture needle,and the concentration of ethanol on the cyst volume reduction rate were analyzed.Results:One month after the operation,the volume reduction rate of single lesion was higher than that of multiple lesions((96.64±8.33)%vs.(90.69±15.08)%,P<0.05),and the volume reduction rate of single lesion was higher than that of multiple lesions three months after operation((96.62±10.85)%vs.(88.79±20.23)%,P<0.05),the volume reduction rate of cysts without separation was greater than that of cysts with separation((96.61±8.66)%vs.(88.49±21.65)%,P<0.05).The use of 75%ethanol concentration showed similar results to those treated with 95%ethanol concentration six months after operation((97.99±4.92)%vs.(90.97±30.91)%,P<0.05).The volume reduction rate of cysts with 17G puncture needle was greater than that with 18G((97.46±6.70)%vs.(80.98±40.75)%,P<0.05).Conclusion:Ultrasound guided ethanol sclerotherapy for OEC is effective,and the treatment method is safe and minimally invasive.For patients with 17G puncture needle,75%medical ethanol,single focus and undivided cysts,more satisfactory curative effect can be achieved after treatment.