微泡超声造影剂辅助高强度聚焦超声治疗子宫腺肌症的有效性和安全性分析

Effectiveness and safety analysis of microbubble ultrasound contrast agent assisted high intensity focused ultrasound in the treatment of adenomyosis

目的分析微泡超声造影剂辅助高强度聚焦超声(HIFU)治疗子宫腺肌症的有效性和安全性。方法选取2020年7月至2021年7月宜春市妇幼保健院妇产科收治的80例子宫腺肌病患者作为研究对象,所有患者随机编号后按照奇偶数分为对照组与研究组,每组40例。两组均应用HIFU治疗,研究组在术前注射微泡超声造影剂辅助治疗。比较两组手术指标、临床指标、不良反应发生情况、女性性生活指数量表(FSFI)评分、Olson婚姻质量问卷(ENRIC)评分。结果研究组治疗时间、高能聚焦时间、出现团块灰度时间均短于对照组,差异有统计学意义(P<0.05);两组消融分数比较差异无统计学意义。治疗后,研究组子宫体积小于对照组,月经量少于对照组,差异有统计学意义(P<0.05);两组病灶体积、痛经程度评分比较差异无统计学意义。研究组治疗区域疼痛发生率为52.50%,低于对照组的80.00%,差异有统计学意义(P<0.05);两组臀部疼痛、神经疼痛、腿部疼痛、肛门坠胀、皮肤不适、下腹疼痛、阴道血性分泌物、发热、骶尾部疼痛、腹胀发生率比较差异无统计学意义。治疗后3个月,两组FSFI、ENRIC评分均高于治疗前,差异有统计学意义(P<0.05),但组间比较差异无统计学意义。结论微泡超声造影剂辅助HIFU治疗子宫腺肌症可缩短高能聚焦时间、出现团块灰度时间及治疗时间,改善患者临床症状,降低术中不良反应发生率,提高患者性生活及婚姻质量,值得临床推广应用。

Objective To analyze the effectiveness and safety of microbubble ultrasound contrast agent assisted high intensity focused ultra-sound(HIFU)in the treatment of adenomyosis.Methods 80 patients with adenomyosis admitted to the Obstetrics and Gynecology department of Yichun Maternal and Child Health Hospital from July 2020 to July 2021 were selected as the study subjects.They were randomly numbered and di-vided into the control group and the study group according to odd/even numbers,with 40 cases in each group.Both groups were treated with HIFU,and the study group was treated with preoperative injection of microbubble ultrasound contrast agent.The surgical indicators,clinical indicators,ad-verse reactions,female sexual function index(FSFI)score,Olson enrich marital inventory(ENRIC)score were compared between the two groups.Results The treatment time,high-energy focusing time,and grayscale appearance time in the study group were shorter than those in the control group,and the differences were statistically significant(P<0.05);there was no difference in ablation scores between the two groups.After treatment,the uterine volume in the study group was smaller than that in the control group,and the menstrual volume was lower than that in the control group,and the differences were statistically significant(P<0.05);there were no differences in lesion volume and dysmenorrhea score between the two groups.The incidence of pain in the treatment area in the study group was 52.50%,which was lower than 80.00%in the control group,and the differ-ence was statistically significant(P<0.05);there were no differences in the incidence of hip pain,nerve pain,leg pain,anal distension,skin discom-fort,lower abdominal pain,vaginal bleeding,fever,sacrococcygeal pain,and abdominal distension between the two groups.At 3 months after treat-ment,the FSFI and ENRIC scores of the two groups were higher than those before treatment,and the difference was statistically significant(P<0.05),but there was no significant difference between the two groups.Conclusion Microbubble ultrasound contrast agent assisted HIFU in the treat-ment of adenomyosis can shorten the time of high energy focusing,the time of mass gray and the time of treatment,improve the clinical symptoms of patients,reduce the incidence of adverse reactions during operation,and improve the quality of sexual life and marriage of patients,which is worthy of clinical promotion and application.