超声引导下射频消融联合米非司酮治疗子宫腺肌症的临床疗效分析

Clinical efficacy of ultrasound-guided radiofrequency ablation combined with mifepristone treatment of adenomyosis

目的探讨超声引导下射频消融联合米非司酮治疗子宫腺肌症的临床疗效。方法回顾性纳入商丘市第四人民医院2018年1月—2021年12月经诊的子宫腺肌症患者96例。根据治疗方式不同,分为单纯超声引导下射频消融组和超声引导下射频消融+米非司酮组。比较两组患者的临床治疗效果、痛经改善情况,以及治疗前后的子宫体积大小和月经量变化,治疗期间不良反应发生情况等。结果超声引导下射频消融+米非司酮组患者治疗总有效率和痛经改善总有效率(97.92%、93.75%)显著高于单纯超声引导下射频消融组(79.17%、77.08%),差异显著(P<0.05)。治疗后,单纯超声引导下射频消融组和超声引导下射频消融+米非司酮组患者子宫体积和月经量均小于治疗前,治疗前后比较,均有显著差异(P<0.05);而超声引导下射频消融+米非司酮组患者治疗后子宫体积和月经量均小于单纯超声引导下射频消融组,差异显著(P<0.05)。超声引导下射频消融+米非司酮组与单纯超声引导下射频消融组不良反应发生率比较(12.50%vs 10.42%),无显著差异(P>0.05)。结论超声引导下射频消融联合米非司酮治疗子宫腺肌症具有较好的临床疗效,可显著缩小患者的子宫体积,减少月经量,缓解痛经,且安全性较高,值得在临床子宫腺肌症治疗中推广使用。

Objective To explore the clinical efficacy of ultrasound-guided radiofrequency ablation combined with mifepristone in the treatment of adenomyosis.Methods Totally 96 patients with adenomyosis admitted to Shangqiu Fourth People's Hospital from Jan.2018 to Dec.2021 were included retrospectively.According to different treatment methods,they were divided into two groups:ultrasound-guided radiofrequency ablation group and ultrasound-guided radiofrequency ablation plus mifepristone group.The clinical treatment effect,improvement of dysmenorrhea,changes of uterine volume and menstrual flow before and after treatment,and adverse reactions during treatment were compared between the two groups.Results The total effective rates of treatment and dysmenorrhea improvement in the ultrasound-guided radiofrequency ablation plus mifepristone group(97.92%,93.75%)were significantly higher than those in the ultrasound-guided radiofrequency ablation group(79.17%,77.08%)(P<0.05).After treatment,the uterine volume and menstrual volume of patients in ultrasound-guided radiofrequency ablation group and ultrasound-guided radiofrequency ablation plus mifepristone group were smaller than before treatment(P<0.05).However,after treatment,the uterine volume and menstrual volume in the ultrasound-guided radiofrequency ablation plus mifepristone group were smaller than those in the ultrasound-guided radiofrequency ablation group(P<0.05).There was no significant difference in the incidence of adverse reactions between the ultrasound-guided radiofrequency ablation plus mifepristone group and the ultrasound-guided radiofrequency ablation group(12.50%vs 10.42%)(P<0.05).Conclusion Ultrasound-guided radiofrequency ablation combined with mifepristone has a good clinical effect in the treatment of adenomyosis,which can significantly reduce the uterine volume of patients,reduce menstrual flow and relieve dysmenorrhea,and has high safety,and is worthy of popularization and use in clinical treatment of adenomyosis.