聚集超声与射频治疗宫颈炎症相关疾病的临床随机对照研究

发布时间：2018-06-10 02:10

本文选题：宫颈炎症相关疾病 + 聚焦超声治疗　；参考：《重庆医科大学》2014年硕士论文

【摘要】：目的:通过宫颈炎症相关疾病的聚焦超声治疗临床随机对照研究,对比观察聚焦超声与射频治疗后宫颈的转归情况，同时行安全性、有效性、经济性、适用性评估，获得一个适用于农村基层推广的聚焦超声治疗新方案。方法:按随机表产生的随机数字将受试者随机分配到聚集超声组和射频组，每组各100例患者。通过治疗后2周、4周、3月、6月、12个月随访观察，对比分析聚焦超声与射频治疗的安全性、有效性、经济性及适用性。结果：1)不良反应：聚焦超声组术后阴道中等排液发生率低于射频组,且术后排液持续时间在16～20天的发生率明显低于射频组（P均0.05）。聚焦超声组术后阴道流血需临床干预的病例数明显少于射频组，且因术后急1性感染出血的病例数也少于射频组（P均0.05）。2)临床疗效研究结果显示：聚焦超声组为98.89%，射频组为98.90%，，两组疗效结果比较无明显统计学差异（P0.05）。SF-36健康调查量表评分结果显示：聚焦超声组与射频组治疗前SF-36量表的8个维度、总体生理健康（Total physical health, TPH）及总体心理健康（Total mentalhealth,TMH）的评分比较无统计学差异(P均0.05)。治疗后随访6个月，聚焦超声组术前、术后SF-36健康调查量表8个维度、TPH及TMH得分的差值与射频组术前、术后的得分差值进行比较，在活力（Vitality,VT）、情感职能（Emotional limitations, RE）、精神健康（Mentalhealth, MH）及TMH方面的得分差值均高于射频组，统计学差异明显（P均0.05）。3）经济学分析：术前两组各项费用比较无明显统计学差异(P均0.05)。治疗后副反应阴道流血临床干预在检查费、处置费两组差异无统计学意义（P均0.05），而药物费、总费用两组比较统计学差异明显（P均0.05）。本研究对术后随访6个月的各项费用的总成本分析结果显示：药物费、检查费及总费用上两组统计学差异明显（P均＜0.01），余费用两组比较无统计学差异（P均＞0.05）。聚集超声组人均治疗总费用1144.74元，射频组人均治疗总费用1244.55元，成本-效果比(C/E)聚焦超声组（11.58）少于射频组（12.58）；进行敏感性分析，假设检查费提高10%、药物费降低10%，两组成本-效果比(C/E)聚焦超声组（11.66）少于射频组（12.58）。4）适用性评价:医生和患者的满意度评价两组结果未见明显统计学差异（P均＞0.05）。结论：聚焦超声与射频治疗宫颈炎症相关疾病疗效相当，但聚焦超声治疗可显著改善患者术后的生存质量，不良反应发生率低，经济、适用可在农村推广使用。
[Abstract]:Objective: to observe the outcome of focused ultrasound and radiofrequency ultrasound in the treatment of cervical inflammation related diseases, and to evaluate the safety, effectiveness, economy and applicability of the treatment. A new scheme of focused ultrasound treatment for rural grass-roots extension was obtained. Methods: the subjects were randomly assigned to the group of aggregated ultrasound and the group of radio frequency according to the random numbers generated by random table, with 100 patients in each group. After 2 weeks, 3 months, 6 months and 12 months of follow-up, the safety and efficacy of focused ultrasound and radiofrequency therapy were compared and analyzed. Results: the incidence of moderate vaginal effusion in focused ultrasound group was lower than that in radio frequency group, and the incidence of postoperative drainage duration in 1620 days was significantly lower than that in radio frequency group (P < 0.05). The number of patients with postoperative vaginal bleeding in focused ultrasound group was significantly less than that in radiofrequency group. And the number of patients with acute first infection bleeding after operation was also less than that of radiofrequency group (P < 0.05).) the results showed that: focused ultrasound group was 98.89 and radiofrequency group 98.90. There was no significant difference between the two groups in the curative effect of the two groups (P0.05SF-36 health survey scale). The results showed that the SF-36 scale had 8 dimensions before treatment in focused ultrasound group and radiofrequency group. There was no significant difference in total physical health (TPHs) and total mental health (THs) scores between the two groups (P < 0.05). After 6 months follow-up, the differences of TPH and TMH scores in 8 dimensions of SF-36 health survey scale were compared with those in radiofrequency group before and after operation. The difference of scores in Vitality, emotional function, mental health, mental health and TMH were higher than that in radio frequency group (P < 0.05). Economic analysis showed that there was no significant difference between the two groups before operation (P < 0.05). There was no significant difference between the two groups in the examination fee and the disposal cost after treatment, but there was significant difference in the drug cost and the total cost between the two groups (P < 0.05). The results of the total cost analysis of the six months follow-up showed that the two groups had significant statistical differences in drug cost, examination fee and total cost (P < 0.01), but there was no significant difference in the remaining cost between the two groups (P > 0.05). The total cost per person in the focused ultrasound group was 1144.74 yuan, and that in the radiofrequency group was 1244.55 yuan, which was lower than that in the C / E focused ultrasound group (11.58%), and the sensitivity analysis was performed. Assuming that the examination fee was increased by 10%, the drug cost was reduced by 10%, the cost-effectiveness of the two groups was lower than that of the C / E focused ultrasound group (11.66) was less than that of the radiofrequency group (12.58 渭 g 路.4): there was no significant difference between the two groups in the evaluation of doctor's and patient's satisfaction (P > 0.05). Conclusion: there is no significant difference between the two groups in the evaluation of doctor's and patient's satisfaction (P > 0.05). The therapeutic effects of focused ultrasound and radiofrequency on cervix inflammation related diseases are equivalent. But the treatment of focused ultrasound can significantly improve the quality of life of patients after operation, the incidence of adverse reactions is low, economic, applicable in rural areas.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.32

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