超声引导下医用乙醇联合聚桂醇硬化治疗卵巢子宫内膜异位囊肿

目的探讨超声引导下医用乙醇联合聚桂醇硬化治疗卵巢子宫内膜异位囊肿（OEC）的疗效。 方法选取2016年9月至2018年5月在哈尔滨医科大学附属第四医院行超声引导下OEC介入治疗的患者88例，共计106个囊肿。依据应用硬化剂的不同，将其分为医用乙醇组（对照组）44例共计53个病灶和医用乙醇联合聚桂醇组（观察组）44例共计53个病灶。于治疗后3个月、6个月分别计算2组患者的治愈率及总有效率，比较2组患者疗效的差异；并对2组患者治疗前后的CA125水平以及治疗中及治疗后的不良反应发生率进行比较分析。 结果治疗后3个月，医用乙醇组治愈率为79.2%，联合组治愈率为73.6%，总有效率均为100.0%，2组比较差异无统计学意义（P>0.05）；治疗后6个月，医用乙醇组治愈率为96.2%，联合组治愈率为92.5%，总有效率均为100.0%，2组比较差异无统计学意义（P>0.05）。2组患者治疗后3个月血清糖类抗原125（CA125）水平均明显下降，与治疗前相比，差异均有统计学意义（t=6.13、8.39，P均<0.01），医用乙醇组中13.6%及联合组中15.9%的患者血清CA125水平未降至正常水平；治疗后6个月2组的血清CA125水平均降至正常范围，与治疗前相比差异均有统计学意义（t=5.86、8.76，P均<0.01）；2组治疗后3个月及6个月组间比较差异均无统计学意义（P均>0.05）。联合组在治疗中及治疗后3~7 d腹痛及醉酒样反应不良反应发生率明显低于医用乙醇组，差异均有统计学意义（P均<0.05）；治疗中2组患者均未出现发热，治疗后3~7 d联合组发热不良反应发生率明显高于医用乙醇组，但差异无统计学意义（P>0.05）。 结论超声引导下医用乙醇联合聚桂醇介入治疗OEC具有与单纯医用乙醇相同的疗效，且不良反应发生率低，对于乙醇过敏及对疼痛敏感的患者选择医用乙醇硬化冲洗联合聚桂醇保留的治疗方法优于单纯医用乙醇硬化法。

Ultrasound guided sclerotherapy with medical ethanol and polycinnamol for treatment of ovarian endometriosis cysts

ObjectiveTo evaluate the therapeutic effects of ultrasound-guided medical ethanol combined with polycinnamol sclerosis in the treatment of ovarian endometriosis cysts. MethodsFrom September 2016 to May 2018, eighty-eight patients (106 cysts) with ovarian endometriosis cyst sclerotherapy guided by ultrasound in the fourth affiliated Hospital of Harbin Medical University were enrolled in this study.According to the different application of sclerosing agent, they were divided into medical ethanol group (control group) with a total of 53 lesions in 44 cases and medical ethanol combined with polycinnamol group (observation group) with a total of 53 lesions. The cure rate and total effective rate of the two groups were calculated at 3 months and 6 months after treatment, and the difference of curative effect between the two groups was compared.The level of CA125 before and after treatment and the incidence of adverse reactions during and after treatment were compared and analyzed. ResultsThree months after treatment, the cure rate of the medical ethanol group was 79.2%, the cure rate of the combined group was 73.6%, the total effective rate was 100%, the difference of the two groups was not significant (P>0.05), the cure rate of the medical ethanol group was 96.2% in 6 months after the treatment, and the cure rate of the combined group was 92.5%. The total effective rate was 100% and the difference of the two groups was not significant (P>0.05). The levels of serum carbohydrate antigen CA125 in the two groups decreased significantly at 3 months after treatment, which were significantly different from those before treatment (t≤6.13, 8.39, P<0.001). The serum CA125 levels in the medical ethanol group and the combined group did not decrease to the normal level. The level of serum CA125 in the two groups decreased to the normal range 6 months after treatment, which was significantly different from that before treatment (t≥5.86, 8.76, P<0.01), but there was no significant difference between the two groups at 3 months and 6 months after treatment (P>0.05).The incidence of abdominal pain and drunken adverse reactions in the combined group was significantly lower than that in the medical ethanol group (P<0.05), and there was no fever in the two groups, and the incidence of adverse reactions to fever in the combined group was significantly higher than that in the medical ethanol group on the 3rd and 7th day after treatment, but there was no significant difference (P>0.05). ConclusionUltrasound guided interventional therapy of medical ethanol combined with polyvinyl alcohol has the same curative effect as medical ethanol alone, and the incidence of adverse reactions is low. For patients with ethanol allergy and pain sensitivity, the treatment method of medical ethanol hardening and flushing combined with polyvinyl alcohol retention is better than that of medical ethanol alone.