高强度聚焦超声与肌瘤挖除术对子宫肌瘤患者术后心理影响分析

目的前瞻性对比子宫肌瘤患者开腹子宫肌瘤挖除术和高强度聚焦超声（nIFU）术前、术后的焦虑、抑郁变化．分析发生心理障碍的原因。方法选择我院2010年10月～2011年10月子宫肌瘤患者100例，按手术方式不同分为挖除术组50例，HIFU组50例。运用汉密尔顿焦虑量表（HAMA）、焦虑自评量表（SAS）、抑郁自评量表（SDS）评估两组患者术前1周、术后1、3个月的焦虑、抑郁状况，并对所获资料进行统计分析。结果HIFU组各量表测评均显示术后1、3个月与术前比较评分降低，差异有统计学意义（P〈0．05或P〈0．01）。挖除术组HAMA、SAS测评均显示术后1个月与术前比较，差异无统计学意义（P〉0．05）；术后3个月与术前比较评分降低明显，差异有高度统计学意义（P〈0．01）；SDS测评显示术后1、3个月与术前比较差异均无统计学意义（均P〉0．05）。HIFU组焦虑抑郁评分改善日益明显，且优于挖除术组。结论HIFU短期内显著改善子宫肌瘤患者焦虑抑郁症状，提高生活质量，符合现代医疗模式的要求。

Analysis on psychological state after myomectomy and high inensity focused ultrasound in the patients with uterus fbroids

Objective To prospectively compare the psychological state including the anxiety and depression for my- omectomy and high inensity focused ultrasound （HIFU） in the patients with uterus fibroids before and after the treat- ment, to analyse the reason of occurrence for mental disorder. Methods 100 cases of the patients with uterus fibroids in our hospital from October 2010 to October 2011 were selected and divided into myomectomy group and HIFU group with 50 cases in each group according to the operation method. Hamiton anxiety scale （HAMA）, self-relating anxiety scale （SAS） and self-relating depression scale （SDS） were investigated in patients with uterus fibroids before and 1,3 months after myomectomy and HIFU, results were analyzed statistically. Results Scores of each scale in HIFU group 1, 3 months after the treatment were all lower than those before the treatment, the differences were all statistically signifi- cant （P 〈 0.05 or P 〈 0.01）. The differences of scores of HAMA, SAS in myomectomy group before and 1 month after the treatment was not statistically significant （P 〉 0.05）; the scores 3 months after the treatment were lower than those before the treatment, the differences were statistically significant （P 〈 0.01）; the differences of scores of SDS before and 1, 3 months after the treatment were not statistically significant （P 〉 0.05）. The scores of anxiety and depression in H1FU group were found improved significantly, and were greater than the myomectomy group. Conclusion The pa- tients with uterus fibroids after HIFU can improve their anxiety and depression symptom, enhance the quality of life. HIFU is eonsistent with the modern social medical model.