本文選題：超聲消融 + 子宮腺肌病��； 參考：《重慶醫(yī)科大學》2014年碩士論文

【摘要】：研究背景：進行性加重的痛經(jīng)為子宮腺肌病的主要臨床表現(xiàn)，同時，患者的生活質(zhì)量也因病受到嚴重的影響。既往研究表明超聲消融治療子宮腺肌病安全可行，可縮小子宮體積并能有效緩解痛經(jīng)、經(jīng)期延長、經(jīng)量增多等臨床癥狀[1-2]。但缺乏更詳盡的對痛經(jīng)緩解情況的評價以及疼痛與生活質(zhì)量的相關性研究，，因此，進一步評價患者痛經(jīng)癥狀緩解及生活質(zhì)量的改善情況更能說明超聲消融治療子宮腺肌病的有效性。 目的：通過評價超聲消融治療子宮腺肌病患者痛經(jīng)癥狀及生活質(zhì)量改善情況，探討超聲消融子宮腺肌病的有效性。 資料和方法：采用重慶海扶醫(yī)療科技股份有限公司研制的JC型聚焦超聲腫瘤治療系統(tǒng)治療38例子宮腺肌病患者，隨訪患者治療后3個月痛經(jīng)癥狀及生活質(zhì)量改善情況并密切觀察患者治療后近期的不良反應。病灶消融率測定采用盆腔增強磁共振圖像（MRI）檢查及HifuMars軟件。痛經(jīng)癥狀評價采用簡式麥吉爾疼痛問卷（SF-MPQ），其中包括三個評分指標：疼痛分級指數(shù)（PRI）、視覺模擬定級（VAS）、現(xiàn)有疼痛強度（PPI）。生活質(zhì)量評定采用子宮肌瘤癥狀及健康相關生活質(zhì)量（UFS-QOL）量表。 結(jié)果：38例患者均行超聲消融治療，治療后無1例嚴重不良反應。病灶消融率為39.0%~89.5%，平均64.1±16.1%。超聲消融治療后3個月，UFS評分較治療前明顯降低（P＜0.05）；QOL評分較治療前明顯提高（P＜0.05）。PRI評分、VAS評分、PPI評分在治療后3月均顯著降低（P＜0.05）；治療后3個月PRI評分、VAS評分、PPI評分的變化量均分別與QOL評分變化量相關。不同消融率的患者臨床療效之間有顯著性差異（P＜0.05）。 結(jié)論：超聲消融子宮腺肌病安全、有效，能顯著緩解痛經(jīng)并提高患者生活質(zhì)量，且痛經(jīng)的緩解程度與生活質(zhì)量的改善相關。病灶消融率越大，痛經(jīng)癥狀的改善與生活質(zhì)量的提高越明顯。
[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 鹵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.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R737.33

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本文編號：2077693