经阴道超声引导穿刺治疗盆腔良性囊性肿块的研究

目的探讨经阴道超声引导穿刺介入治疗盆腔不同良性囊性肿块的疗效和影响因素.方法对129例患者共161个囊性肿块进行经阴道超声引导下穿刺治疗.其中子宫内膜异位囊肿 38个(A组),卵巢非赘生性囊肿 21个(B组),阔韧带囊肿 16个(C组),盆腔包裹性积液 39个(D组),输卵管积水 47个(E组).A、B、C三组采用无水乙醇硬化治疗,D、E二组采用灭滴灵、丁胺卡那霉素等抗炎治疗,术后第 1、3、6个月各随访一次经阴道超声检查.结果 161个囊性肿块术后1、3、6个月的总治愈率分别为59.0%,65.8%,60.2%.A、B、C三组的治愈率差异无显著意义(P＞0.05).A、B、C三组的治愈率与D、E二组的治愈率有显著差异(P＜0.001).A、B、C三组术后1个月的治愈率较术后 3、6个月低而显效率则较高.D、E二组治愈率随着随访时间延长而降低.结论经阴道超声引导穿刺治疗子宫内膜异位囊肿、卵巢非赘生性囊肿及阔韧带囊肿均有显著效果,疗效判断以术后 3个月较为合理.盆腔包裹性积液及输卵管积水的疗效欠佳.

Study on Transvaginal Ultrasound Guided Puncture and Therapy in Pelvic Cysts

Objective To investigate the different effects and courses of transvaginal ultrasound (TVUS) guided puncture and therapy in the different pelvic cysts.Methods The TVUS guided puncture and therapy was performed on 129 patients with 161 pelvic cysts,including 38 endometrial cysts(group A),21 ovarian non-neoplastic cysts (group B),16 broad ligament cysts(group C),39 encapsulated pelvic effusion (group D) and 47 hydrosalpinx(group E).Group A,B and C were treated by injection of 99.9% ethanal,group D and E were treated with local administration of antibiotics.After TVU guided puncture and therapy,the patients were followed up regularly with TVUS.Results The differences of the cure rate were not significant among group A,B and C (P>0.05).The cure rate of the group A,B and C were higher than those of group D and E(P<0.01).The cure rate of group A,B and C was lower in one months follow-up after interventional procedure than those in three and six month follow-up post the intervention, but the obvious effective rate was higher in one month after treatment than those in three and six month.The longer the follow-up time,the lower the cure rate of the group D and E.Conclusions .The TVUS guided puncture and therapy is a high effective treatment for group A,B and C.But for patients of group D and E,the interventional treatment is not effective and further investigation of other alternatives should be performed.