摘要
目的:探讨超声引导下聚桂醇硬化联合米非司酮治疗子宫肌瘤(UF)效果及对患者宫颈微循环的影响。方法:选择本院2022年10月-2024年10月诊治的UF患者180例,随机分为两组各90例,对照组采用米非司酮治疗,观察组给予超声引导聚桂醇硬化联合米非司酮治疗,比较两组治疗效果、肌瘤体积、子宫体积,性激素促黄体生成素(LH)、雌二醇(E_(2))、促卵泡生长激素(FSH),血管内皮功能血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(BFGF),子宫内膜血流指数(FI)、血管化指数(VI)、血管化血流指数(VFI),宫颈局部微循环血流速度、阻力指数(RI)和搏动指数(PI)、不良反应及随访(7~31个月,随访中位数为20个月)UF复发情况。结果:治疗后,观察组总有效率(84例,93.3%)高于对照组(75例,83.3%)(P<0.05),两组UF体积、子宫体积、VEGF、BFGF、LH、E_(2)、FSH、微血管管径、血流速度均不同程度降低,FI、VI、VFI、RI、PI均不同程度升高,但观察组变化幅度优于对照组(P<0.05)。两组总不良反应发生率(7.8%比13.3%)及随访期间UF复发率(5.7%、11.1%)均无差异(P<0.05)。结论:超声引导聚桂醇硬化合并米非司酮治疗UF临床效果提高,能更有效缩小肌瘤体积与子宫体积,改善性激素水平、血管内皮功能、子宫内膜血流和宫颈局部微循环等宫颈微环境指标,安全性较好。
Objective:To investigate the effect of the ultrasound-guided polidocanol sclerotherapy combined with mifepristone for treating patients with uterine fibroids(UF),and to study its impact on the cervical microcirculation of the patients.Methods:A total of 180 patients with UF treated in the hospital were selected and were randomly divided into two groups from October 2022 to October 2024.90 patients in the control group received the mifepristone treatment,while 90 patients in the observation group were given the ultrasound-guided polidocanol sclerotherapy combined with mifepristone treatment.The therapeutic effect,the uterine fibroid volume,the uterine volume,the levels of the luteinizing hormone(LH),estradiol(E_(2)),follicle-stimulating hormone(FSH),vascular endothelial function vascular endothelial growth factor(VEGF)and basic fibroblast growth factor(BFGF),the values of the endometrial blood flow parameters,such as flow index(FI),vascularization index(VI)and vascular flow index(VFI),the values of the cervical local microcirculation blood flow parameters,such as velocity,resistance index(RI)and plasticity index(PI),and the rates of the adverse reactions and the recurrence of uterine fibroids(UF)within 7-31 months(median of 20 months)after treatment of the patients were compared between the two groups.Results:The total effective rate of the patients in the observation group(84 cases,93.3%)was significantly higher than that(75 cases,83.3%)of the patients in the control group(P<0.05).The volumes of UF and uterus,the levels of VEGF,BFGF,LH,E_(2)and FSH,the microvascular diameter and the blood flow velocity of the patients in both groups had decreased to varying degrees,while the values of FI,VI,VFI,RI and PI of the patients in both groups had increased to varying degrees,however,the changes of which of the patients in the observation group were significantly better than those of the patients in the control group(P<0.05).There were no significant differences in the total incidence of adverse reactions(7.8%vs.13.3%)and the recurrence rate of UF during follow-up(5.7%vs.11.1%)of the patients between the two groups(P<0.05).Conclusion:The ultrasound-guided polidocanol sclerotherapy combined with mifepristone for treating the patients with UF can increase their clinical effect,reduce their fibroid and uterine volumes,improve their cervical microcirculation indexes,vascular endothelial function,endometrial blood flow and cervical local microcirculation,and increase their sex hormone levels,and with the good safety.
作者
林燕
钱美娟
姜智明
韩亚琴
LIN Yan;QIAN Meijuan;JIANG Zhiming;HAN Yaqin(The Sixth People's Hospital of Nantong,Nantong,Jiangsu Province,226000)
出处
《中国计划生育学杂志》
2025年第10期2204-2210,共7页
Chinese Journal of Family Planning
关键词
子宫肌瘤
米非司酮
超声
聚桂醇
宫颈微循环
性激素
临床疗效
复发
Uterine fibroid
Mifepristone
Ultrasound
Polidocanol
Cervical microcirculation
Sex hormone
Clinical efficacy
Recurrence
