超声消融子宫腺肌病临床症状改善与生活质量评价

发布时间：2018-06-28 10:31

本文选题：超声消融 + 子宫腺肌病　；参考：《重庆医科大学》2014年硕士论文

【摘要】：研究背景：进行性加重的痛经为子宫腺肌病的主要临床表现，同时，患者的生活质量也因病受到严重的影响。既往研究表明超声消融治疗子宫腺肌病安全可行，可缩小子宫体积并能有效缓解痛经、经期延长、经量增多等临床症状[1-2]。但缺乏更详尽的对痛经缓解情况的评价以及疼痛与生活质量的相关性研究，，因此，进一步评价患者痛经症状缓解及生活质量的改善情况更能说明超声消融治疗子宫腺肌病的有效性。目的：通过评价超声消融治疗子宫腺肌病患者痛经症状及生活质量改善情况，探讨超声消融子宫腺肌病的有效性。资料和方法：采用重庆海扶医疗科技股份有限公司研制的JC型聚焦超声肿瘤治疗系统治疗38例子宫腺肌病患者，随访患者治疗后3个月痛经症状及生活质量改善情况并密切观察患者治疗后近期的不良反应。病灶消融率测定采用盆腔增强磁共振图像（MRI）检查及HifuMars软件。痛经症状评价采用简式麦吉尔疼痛问卷（SF-MPQ），其中包括三个评分指标：疼痛分级指数（PRI）、视觉模拟定级（VAS）、现有疼痛强度（PPI）。生活质量评定采用子宫肌瘤症状及健康相关生活质量（UFS-QOL）量表。结果：38例患者均行超声消融治疗，治疗后无1例严重不良反应。病灶消融率为39.0%~89.5%，平均64.1±16.1%。超声消融治疗后3个月，UFS评分较治疗前明显降低（P＜0.05）；QOL评分较治疗前明显提高（P＜0.05）。PRI评分、VAS评分、PPI评分在治疗后3月均显著降低（P＜0.05）；治疗后3个月PRI评分、VAS评分、PPI评分的变化量均分别与QOL评分变化量相关。不同消融率的患者临床疗效之间有显著性差异（P＜0.05）。结论：超声消融子宫腺肌病安全、有效，能显著缓解痛经并提高患者生活质量，且痛经的缓解程度与生活质量的改善相关。病灶消融率越大，痛经症状的改善与生活质量的提高越明显。
[Abstract]:Background: progressive aggravation of dysmenorrhea is the main clinical manifestation of adenomyosis. Previous studies have shown that ultrasound ablation is safe and feasible in the treatment of adenomyosis. It can reduce the volume of uterus and relieve dysmenorrhea effectively. But in the absence of a more detailed evaluation of dysmenorrhea relief and a study on the correlation between pain and quality of life, Further evaluation of the relief of dysmenorrhea symptoms and the improvement of quality of life can explain the effectiveness of ultrasound ablation in the treatment of adenomyosis. Objective: to evaluate the effect of ultrasound ablation on dysmenorrhea and quality of life (QOL) in patients with adenomyosis. Materials and methods: 38 patients with adenomyosis were treated with JC focused ultrasound tumor therapy system developed by Chongqing Haifu Medical Technology Co., Ltd. The symptoms of dysmenorrhea and the improvement of quality of life were observed 3 months after treatment. The ablation rate was measured by pelvic enhanced magnetic resonance imaging (MRI) and HifuMars software. The symptoms of dysmenorrhea were evaluated by simple McGill pain questionnaire (SF-MPQ), which included three indexes: pain grading index (PRI), visual analogue grading (VAS), and existing pain intensity (PPI). The quality of life (QOL) was assessed by UFS-QOL scale for uterine leiomyoma symptoms and health-related quality of life (UFS-QOL). Results all 38 cases were treated by ultrasound ablation, none of them had serious adverse reaction after treatment. The ablation rate was 39. 0% and 89. 5%, with an average of 64. 1 卤16. 1%. The UFS scores decreased significantly 3 months after ultrasound ablation (P < 0.05). The scores of QOL increased significantly (P < 0.05). The VAS scores and PPI scores decreased significantly 3 months after treatment (P < 0.05). The changes of PRI scores and VAS scores and PPI scores were correlated with QOL scores 3 months after treatment. There was significant difference in clinical efficacy among patients with different ablation rates (P < 0.05). Conclusion: ultrasound ablation of adenomyosis is safe and effective. It can significantly relieve dysmenorrhea and improve the quality of life. The degree of relief of dysmenorrhea is related to the improvement of quality of life. The larger the ablation rate, the more obvious the improvement of dysmenorrhea symptom and quality of life.
【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】：R737.33

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