聚焦超声治疗外阴上皮内非瘤样病变30例长期临床观察

目的 探讨聚焦超声治疗外阴上皮内非瘤样病变的临床疗效。方法 2000～2002年9月我院共收治外阴上皮内非瘤样病变60例，均经病理证实。其中鳞形细胞增生型30例，硬化苔癣型25例，硬化苔癣型伴鳞形细胞增生5例。患者年龄12～69岁．平均年龄34．81岁，病程〈3年10例，3～10年38例，〉10年12例。随机分为超声组30例，对照组30例。聚焦超声治疗功率为4．0W，采用连续直线扫描方式，治疗时间20～40min，通常治疗1次。对照组用药物治疗，使用3个月。于第1、3、6个月依近期治愈标准判断疗效。结果 超声组临床治愈12例，占40％，显效15例，占50％，好转3例，占10％，总有效率为100％。不同类型病理间疗效比较，差异无统计学意义（P〉0．05）。不同病程疗效比较，差异显著。对照组;临床治愈1例，占3．33％，显效5例，占16．7％，好转19例，占63．3％；无效4例，占13．3％，但停止治疗1～2个月，复发21例，占70％。结论 本资料表明聚焦超声治疗外阴上皮内非瘤样病变是快速、安全、有效的。

Clinical report of the noneoplastic epithelial disorders of vulva treated with focused ultrasound therapy

Objective To investigate the clinical curative effect of treating nonneoplastic epithelial disorders of vulva with focused ultrasound treatment.Methods Seventy-five patients(aging 12-69,mean 34.81years) with nonneoplastic epithelial disorders of vulva confirmed by pathology,including thirty-eight patients of squamous hyperplasia and twenty-eight patients of lichen sclerosus and nine patients of lichen sclerosus with squamous hyperlasia.All of them were randomly assigned to two groups.Fourty-five cases of the ultrasound group were treated with ultrasound treatment instrument(model: CZF)made in Chongqing Haifu(HIFU) Technology Co.,Ltd.The power of 4.0W was used for 20-30min in each session.The other 30 patients were received medical treatment.A duration of 90d is treatment course.Results Fourty-five patients in ultrasound group recovered at different degrees,among them 12 cases were cured(40%),15 cases were found much more improved(50%),3 cases were improved(10%).The effective rate was 100%.The pathological changes indicated that the squamous epithelium of vulva had recoverd normal stratification and thickness.There was a significant difference between pre-and post-treatment.Different pathological cases had nonremarkable difference,and different disease course had remarkable difference.In the control group,1 case was cured(3.33%),5 cases were found much more improved(16.7%)and 19 cases were improved(63.3%).But 21 cases were found relapsed pruritus of vulva in 1-2 months after treatment.Conclusion The focused ultrasound is a new effective and safe method in the treatment of nonneoplastic epithelial disorders of vulva.