超声引导下经皮射频消融子宫腺肌症的近期疗效观察

摘要 目的：探讨超声引导下经皮射频消融（RFA）治疗子宫腺肌症（ADM）的近期疗效。方法：选取2016年3月-2020年10月我院收治的ADM患者共计138例作为研究对象，根据数字随机表法将患者分为对照组和观察组，每组69例，对照组接受手术切除病灶治疗，观察组接受RFA治疗。比较两组患者子宫体积变化情况、临床症状、血红蛋白变化、术后不良反应发生情况。结果：两组患者术后子宫体积逐渐缩小，术后各随访时期与术前比较，差异均有统计学意义（P＜0.05），术后1个月与术后3个月、6个月与12个月分别比较，差异均有统计学意义（P＜0.05），术后3个月、6个月与12个月比较，差异无统计学意义（P＞0.05）。观察组月经过多、痛经等临床症状缓解率明显高于对照组（P＜0.05），两组下腹包块、泌尿系统症状等临床症状缓解率比较（P＞0.05），两组均无临床症状加重情况发生。两组患者术前、术后1天血红蛋白情况比较（P＞0.05），观察组术后6个月血红蛋白量明显多于对照组（P＜0.05）。两组少量阴道排液及出血、月经紊乱、下腹痛、白带异常等轻微并发症总发生率比较无差异（P＞0.05）。少量阴道排液、出血患者持续10～60天自愈；月经紊乱患者给予肾上腺色腙片或激素处理；下腹痛患者持续时间约为2周，予镇痛处理；白带异常患者嘱其注意清洁卫生，预防感染。结论：超声引导下水冷循环电极经皮RFA治疗ADM具有微创、安全、高效的优势，可明显减小子宫体积，缓解临床症状，提高血红蛋白含量。

Short-term Efficacy of Ultrasound-guided Percutaneous Radiofrequency Ablation of Uterine Adenomyosis

ABSTRACT Objective: To investigate the short-term efficacy of ultrasound-guided percutaneous radiofrequency ablation (RFA) in the treatment of adenomyosis (ADM). Methods: A total of 138 cases of ADM patients admitted to our hospital from March 2016 to October 2020 were selected as research objects. According to the method of digital random table, the patients were divided into control group and observation group, with 69 cases in each group. The control group received surgical resection of the lesion, and the observation group received RFA treatment. Uterine volume changes, clinical symptoms, hemoglobin changes and postoperative adverse reactions were compared between the two groups. Results: The postoperative uterine volume of the two groups was gradually reduced, and the postoperative follow-up period was compared with the preoperative period, the differences were statistically significant (P<0.05). The postoperative 1 month and 3 months, 6 months and 12 months were respectively compared, and the differences were statistically significant (P<0.05). The postoperative 3 months, 6 months and 12 months were compared, The difference was not statistically significant (P>0.05). The remission rates of menorrhagia, dysmenorrhea and other clinical symptoms in the observation group were significantly higher than those in the control group (P<0.05), and the remission rates of lower abdominal mass, urinary symptoms and other clinical symptoms were compared between the two groups (P>0.05), and no exacerbation of clinical symptoms occurred in the two groups. The hemoglobin level of the two groups before and 1 day after surgery was compared (P>0.05), and the hemoglobin level of the observation group was significantly higher than that of the control group 6 months after surgery (P<0.05). The total incidence of minor complications such as small vaginal drainage and bleeding, menstrual disorders, lower abdominal pain and leucorrhea were compared between the two groups (P>0.05). Patients with small amounts of vaginal drainage and bleeding will heal themselves for 10 to 60 days; Patients with menstrual disorders were given adrenal color hydrazone tablets or hormone treatment; Patients with lower abdominal pain lasted about 2 weeks and were treated with analgesia. Patients with abnormal leucorrhea advised them to pay attention to cleanliness and hygiene to prevent infection. Conclusion: The treatment of percutaneous RFA with ultrasound-guided water cold circulation electrode for ADM has the advantages of minimally invasive, safe and efficient, which can significantly reduce the volume of the uterus, relieve clinical symptoms, and improve the hemoglobin content.