彩色多普勒超声引导微波治疗仪微波消融治疗子宫腺肌症的临床疗效研究

Observation on the clinically curative effect of color ultrasound diagnostic instrument combined with microwave therapeutic instrument in the treatment of microwave ablation for adenomyosis of uterus

目的:探讨彩色多普勒超声引导微波治疗仪微波消融治疗子宫腺肌症的临床疗效。方法:选取医院妇科收治的90例子宫腺肌症患者,采用随机数表法将其分为联合组和对照组,每组45例,联合组采用微波消融联合术后1个月超声引导下诊刮术方案治疗,对照组采用微波消融术治疗,对比两组治疗前后月经失血图(PBAC)评分和痛经程度评分,比较血清糖类抗原125(CA125)、白细胞(WBC)、血红蛋白(Hb)及血清C反应蛋白(CRP)的变化,以及磁共振弥散加权成像(DWI)相关参数表观弥散系数(ADC)及子宫体积,对比临床疗效。结果:治疗前两组患者的PBAC评分和痛经程度评分比较差异无统计学意义;治疗3个月后,联合组患者的PBAC评分显著低于对照组,差异有统计学意义(t=-2.850,P<0.05),两组患者治疗6个月后的PBAC评分、治疗3个月及治疗6个月后的痛经程度评分比较,差异无统计学意义;治疗前,两组患者的子宫体积、病灶区ADC值比较,差异无统计学意义;治疗3个月和6个月后,联合组患者的子宫体积显著低于对照组,差异有统计学意义(t=-3.168,t=-3.532;P<0.05);联合组治疗3个月后的病灶区ADC值低于对照组,差异有统计学意义(t=-2.863,P<0.05);两组患者治疗6个月后的病灶区ADC值比较,差异无统计学意义;治疗前两组患者的血清CA125、WBC、Hb及CRP水平比较,差异无统计学意义;治疗6个月后,联合组患者的血清CA125水平低于对照组,外周血Hb显著高于对照组,差异有统计学意义(t=-3.148,t=2.452;P<0.05);联合组总体疗效优于对照组,差异具有统计学意义(Z=-3.163,P<0.05)。结论:微波消融联合超声引导下诊刮术治疗子宫腺肌症较单独应用微波消融术治疗能够取得更好的临床效果。

Objective:To investigate the clinical effect of microwave ablation combined with ultrasound-guided curettage in treating patients with adenomyosis of uterus.Methods:In this study,a total of 90 patients with adenomyosis of uterus admitted to hospital were selected as the research objects.They were divided into the combination group and the control group according to random number table,with 45 cases in each group.The combination group adopted microwave ablation combined with ultrasound-guided curettage 1 month after surgery,and the control group adopted the treatment with microwave ablation.The scores of pictorial blood assessment chart(PBAC)and the degree of dysmenorrhea before and after treatment between two groups were compared,and the changes of serum carbohydrate antigen 125(CA125),white blood cells(WBC),hemoglobin(Hb)and serum C-reactive protein(CRP)also were compared,as well as the apparent diffusion coefficient(ADC)of the relevant parameters of diffusion weighted imaging(DWI)and uterine volume.Finally,the comparison of clinically curative effect between two groups were compared.Results:There were no statistically significant differences in the PBAC score and the score of dysmenorrhea severity between the two groups of patients before treatment.After 3 months of treatment,the PBAC scores of patients in the combination group were significantly lower than that in the control group,with a statistically significant difference(t=-2.850,P<0.05).There were no statistically significant differences in the PBAC scores at the 6th month after treatment,and the scores of dysmenorrhea degree at the 3rd month and the 6th month after treatment between the two groups.Before treatment,there were no statistically significant differences in the uterine volume and the ADC value of the lesion area between the two groups.At the 3rd month and the 6th month after treatment,the uterine volume of the combination group was significantly lower than that of the control group,with a statistically significant difference(t=-3.168,t=-3.532,P<0.05),respectively.The ADC value of the lesion area in the combination group was significantly lower than that of the control group after 3 months of treatment,with a statistically significant difference(t=-2.863,P<0.05).There was no statistically significant difference in ADC values in the lesion area between the two groups after 6 months of treatment.There were no statistically significant differences in the levels of serum CA125,WBC,Hb and CRP between the two groups of patients before treatment.After 6 months of treatment,the serum CA125 level of patients in the combination group was significantly lower than that in the control group,and the peripheral blood Hb of the former was significantly higher than that of the control group,with statistically significant differences(t=-3.148,t=2.452,P<0.05),respectively.The overall curative efficiency of the combination group was significantly better than that of the control group,with a statistically significant difference(Z=-3.163,P<0.05).Conclusion:The obtained clinical effect of microwave ablation combined with the curettage under ultrasound guidance is better than that of single microwave ablation in treating adenomyosis.