超声引导介入治疗卵巢子宫内膜异位囊肿的疗效评估

卵巢子宫内膜异位囊肿；介入性超声治疗；腹腔镜囊肿剔除术

Efficacy evaluation of ultrasound-guided interventional therapy for ovarian endometriotic cysts

Objective To evaluate the clinical effect of ultrasound-guided interventional therapy for ovarian endometriotic cysts. Methods A total of 143 patients with clinically diagnosed ovarian endometriotic cysts treated in the Second Xiangya Hospital of Central South University between March 2014 and March 2016 were randomly divided into control group and experimental group. The 71 patients in control group were treated with laparoscopic cystectomy, while the 72 patients in experimental group received ultrasound interventional puncture. In experimental group, the fluid in the capsule cavity was aspirated with a puncture needle, and the capsule cavity was rinsed with normal saline. After rinsing, the ethanol was injected according to the cyst size. The amount of anhydrous ethanol was about 70% of the cavity fluid, and after 10 minutes of indwelling, the aspiration of anhydrous ethanol was performed. Six months after treatment, patients were followed-up for understanding the symptoms improvement, pregnancy and recurrence. The levels of luteinizing hormone and follicle estrogen in the serum, and the number of antecedullary follicles detected by ultrasound were measured to assess the effects of both modalities on ovarian functions. Results The operation time in control group was significantly higher than that in experimental group ［(60.24±5.33) min vs (42.13±3.17) min, P<0.05］. After the treatment, cysts were disappeared in experimental group. In control group, cysts were removed in 65 cases after receiving laparoscopic surgery, and laparotomy were performed for 6 patients with uterine fibroids. The follicular estrogen in control group was higher than that in experimental group ［(19.54±3.62) U/L vs (15.27±3.36) U/L, P<0.05］. The cure rate of experimental group was 94%, significantly higher than 66% in control group (P<0.05). The recurrence rate of control and experimental groups were 25% and 9%, with significant differences (P<0.05). Conclusion Interventional ultrasound therapy is a simple and safe and effective treatment for ovarian endometriosis cysts for it achieves a high cure rate, effectively reduces the recurrence rate, and causes less ovarian damages, without affecting the reproductive function.