目的 观察超声引导射频消融联合米非司酮治疗子宫肌瘤对患者子宫功能的影响,旨在指导未来安全有效的子宫肌瘤治疗方法。方法 回顾性收集2017年6月至2019年6月期间本院收治的子宫肌瘤患者96例病历资料,按照治疗方式不同将其分为两组,将子宫肌瘤剔除术+米非司酮治疗患者51例纳入对照组,将超声引导射频消融+米非司酮治疗患者45例纳入观察组。术后用药4周为1个疗程,用药3个疗程。抽取患者治疗前、治疗3个疗程后静脉血,检测血清性激素[促黄体生长素(LH)、雌二醇(E2)、促卵泡生长激素(FSH)]水平,采用彩色多普勒超声诊断仪检测治疗前、治疗3个疗程后患者子宫内膜厚度、子宫体积及子宫内膜各血流参数[血流指数(FI)、血管化指数(VI)、血管化血流指数(VFI)],并对比上述检各项检测指标。结果 两组治疗前后LH、E2、FSH水平的变化,对照组较治疗前均明显升高(P＜0.05),观察组较治疗前均无变化(P＞0.05),且均低于对照组,差异有统计学意义(P＜0.05)；两组治疗后子宫内膜厚度均较治疗前增加,子宫体积较治疗前缩小,且观察组子宫内膜厚度大于对照组,子宫体积小于对照组,差异有统计学意义(P＜0.05)；治疗后,两组FI、VI、VFI、VFI值均较治疗前升高,且观察组高于对照组,差异有统计学意义(P＜0.05)。结论 超声引导射频消融联合米非司酮治疗子宫肌瘤,更利于患者术后性激素水平的调节,患者子宫内膜血流改善、子宫内膜厚度增加、子宫体积缩小,不仅不会对患者子宫功能带来不理影响,在一定程度上更利于术后子宫恢复。

Objective To observe the effect of ultrasound-guided radiofrequency ablation combined with mifepristone on uterine function in patients with uterine fibroids, and to provide guidance for safe and effective treatment methods of uterine fibroids. Methods The medical records of 96 patients with uterine fibroids who admitted in the hospital from June 2017 to June 2019 were retrospectively analyzed. They were divided into two groups according to treatment methods, 51 patients with myomectomy and mifepristone were included in control group, and 45 patients with ltrasound-guided radiofrequency ablation combined with mifepristone were included in observation group. The 4 weeks of medication after the operation was 1 course, and the medication lasted for 3 courses. The venous blood of patients was taken before treatment and after treatment for 3 courses, and the serum sex hormones [luteinizing hormone (LH), estradiol (E2), follicle stimulating hormone (FSH)] were detected. Color Doppler ultrasound was used to detect the endometrial thickness, uterine volume, and endometrial blood flow parameters [flow index (FI), vascularization index (VI), vascularization flow index (VFI)] of patients before treatment and after treatment for 3 courses, and the above-mentioned detection indexes were compared. Results The changes of LH, E2 and FSH levels before and after treatment in the two groups were compared, control group was significantly higher than that before treatment (P<0.05), and observation group had no changes compared with that before treatment (P>0.05), and they were lower than those in control group (P<0.05); After treatment, the endometrial volume of two groups increased compared with that before treatment, and the uterine volume decreased compared with that before treatment, the endometrial volume of observation group was larger than that of control group, and the uterine volume was smaller than that of control group (P<0.05); After treatment, the values of FI, VI, VFI, and VFI in the two groups were higher than those before treatment, and observation group was higher than control group (P<0.05). Conclusion Ultrasound-guided radiofrequency ablation combined with mifepristone in treatment of uterine fibroids can regulate postoperative sex hormone levels, improve endometrial blood flow, increase endometrial thickness and reduce uterine volume, it will not have adverse effect on the uterine function of patients, and will be more conducive to postoperative uterine recovery to a certain extent.