摘要
目的观察介入性超声治疗卵巢子宫内膜异位囊肿的临床疗效,发现影响手术疗效的相关因素.方法对38例卵巢子宫内膜异位囊肿患者进行介入性超声治疗.术后1月、3月、6月、12月、24月定期随访超声,观察手术疗效.观察患者年龄、囊肿大小、囊肿壁厚度、囊肿分房性、囊肿的侧别、术中无水乙醇留置时间达标与否,术后残留包块与否、术后Gn RH-a使用与否、内异症手术史与否、患者血清CA125阳性与否等十项指标,采用Logistic回归分析这10项指标是否为影响穿刺治疗手术近期、中期复发率的影响因素.结果术后6月Logistic回归分析显示:患者年龄、残余包块与否、囊肿壁厚度OR值大于1,为影响手术疗效的危险因素;术后Gn RH-a的使用,OR值小于1,为影响手术疗效的保护因素.术后24月Logistic回归分析结果显示:年龄、囊肿壁厚度、囊肿侧别OR值大于1,为影响手术中期疗效的危险因素;术后Gn RH-a的使用,OR值小于1,为影响手术中期疗效的保护因素.近期复发率与中期复发率经χ2检验,P<0.05,有统计学意义,近期复发率低于中期复发率.结论育龄期子宫内膜异位囊肿患者,年龄较大、囊肿壁厚度较厚、术后有残余包块为影响介入性超声治疗卵巢子宫内膜异位囊肿近期疗效的危险因素,术后药物Gn RH-a的使用为保护性因素.育龄期卵巢子宫内膜异位囊肿者,年龄较大、囊肿壁厚度较厚、双侧囊肿为影响介入性超声治疗卵巢巧克力囊肿中期疗效的危险性因素,药物Gn RH-a的使用为保护性因素.介入性超声治疗卵巢巧克力囊肿近期复发率明显低于中期复发率.
Objective To find out the influencing factors for the recurrence rate of ovarian endometrial cysts through observing the clinical effects of interventional ultrasound treatmtent. Methods 38 cases of ovarian endometrial cysts were transvaginal or abdominal ultrasound-guided punctured. All the cases were followed up after the operation and the treatment effect was observed. All patients clinically interviewed were given physical examination and uhrasonography. The factors measured included： age at surgery, serum CA125, history of operation for endometriosis, side of endometrial cyst, size of cyst, thickness of cyst, alcohol in operation or not, using GnrRH-a after operation or not, residual cyst or not. The recurrent rate and its predictive factors were evaluated and the multivariate logistic regression was conducted to determinate the predictive factors for recurrence of endometriosis. Results The related factors and their OR by muhivariable analysis after 6 months were as follows： patients＇ age, residual cyst or not, the thickness of cyst were into the model, the OR value was greater than 1, theywere risk factors. Meanwhile, with the use of postoperative GnRH-a, the OR value is less than 1, it was protective factor. The related factors and their OR by multivariable analysis after 24 moth were as follows ： patients＇ age, side of cyst, the thickness of cyst were into the model, the OR value was greater than 1, they were risk factors. Meanwhile, with the use of postoperative GnRH-a, the OR value was less than 1, it was protective factor. Postoperative recurrence rate after 6 moths and the postoperative recurrence rate after 24 months did x 2 test （P〈0.05）, the recent recurrence rate was lower than the middle rate of relapse. Conclusions The risk factors for short-term recurrence of ultrasound-guided puncture endometrial cyst include Age of patients, Thickness of cyst, The residual of cyst. Whereas the protective factors include used GnRH-a after operation. The risk for Mid-term recurrence of ultrasound-guided puncture endometrial cyst include Age of patients, Thickness of cyst, The side of cyst. Whereas the protective factors include used GnRH-a after operation. At the same time, the subject study shows that short-term recurrence rate of ultrasound-guided puncture treatment for ovarian endometrial cyst significantly is lower than the mid-term＇ s, short-term curative effect is better.
出处
《昆明医科大学学报》
CAS
2015年第7期100-104,共5页
Journal of Kunming Medical University
基金
云南省科技厅-昆明医科大学联合专项基金资助项目(2012FB038)
关键词
卵巢子宫内膜异位囊肿
介入性超声
复发相关因素
Ovarian endometrial cysts
Interventional Ultrasound
Recurrence relative factors
