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高强度聚焦超声治疗子宫腺肌病中影响治疗决策的因素:一项回顾性研究。

Factors influencing treatment decisions in HIFU treatment of adenomyosis: A retrospective study.

作者信息

Zhong Qiao, Yang Mei-Jie, Hu Yan, Jiang Li, Yu Jing-Wen, Chen Jin-Yun, Chen Wen-Zhi

机构信息

State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.

College of Medical Informatics, Chongqing Medical University, Chongqing, China.

出版信息

Front Surg. 2022 Oct 12;9:941368. doi: 10.3389/fsurg.2022.941368. eCollection 2022.

Abstract

OBJECTIVE

To explore the influencing factors of decision-making in patients with adenomyosis, who are receiving high-intensity focused ultrasound (HIFU) treatment.

METHODS

A total of 776 patients with adenomyosis were enrolled into HIFU group (241 cases) and hysterectomy group (535 cases) according to the treatment methods. The general data, clinical symptoms, marital and childbearing history, and economic status were compared between the two groups, and factors with < 0.05 were introduced into multivariate logistic regression analysis to determine the determinants of patients choosing HIFU.

RESULTS

The average age of the patients in the HIFU group was 39.1 ± 5.2 years, which was lower than that in the hysterectomy group, which was 45.1 ± 3.9 years (< 0.05). The basic medical insurance for urban workers in the HIFU group was more than the hysterectomy group (< 0.05). 95.9% of the hysterectomy group had no desire to have children, compared to 60.6% of the HIFU group, the difference was significant (< 0.05). The treatment costs of HIFU group were significantly lower than that of hysterectomy group (< 0.05). The main symptoms of the two groups were dysmenorrhea, menorrhagia, and secondary anemia. The results of multivariate logistic regression analysis showed that 31-40 years old, fertility desire, dysmenorrhea, menorrhagia, anemia and dizziness and fatigue were the influencing factors for the decision-making of HIFU for patients with adenomyosis.

CONCLUSION

31-40 years old, fertility desire, dysmenorrhea, menorrhagia, anemia and dizziness and fatigue were the influencing factors for patients to choose HIFU treatment. HIFU therapy has emerged as a new option for patients with adenomyosis as an alternative to hysterectomy.

摘要

目的

探讨子宫腺肌病患者接受高强度聚焦超声(HIFU)治疗时决策的影响因素。

方法

根据治疗方法,将776例子宫腺肌病患者分为HIFU组(241例)和子宫切除术组(535例)。比较两组患者的一般资料、临床症状、婚育史及经济状况,将P<0.05的因素纳入多因素logistic回归分析,以确定患者选择HIFU的决定因素。

结果

HIFU组患者的平均年龄为39.1±5.2岁,低于子宫切除术组的45.1±3.9岁(P<0.05)。HIFU组的城镇职工基本医疗保险参保人数多于子宫切除术组(P<0.05)。子宫切除术组95.9%的患者无生育意愿,而HIFU组为60.6%,差异有统计学意义(P<0.05)。HIFU组的治疗费用显著低于子宫切除术组(P<0.05)。两组的主要症状均为痛经、月经过多和继发性贫血。多因素logistic回归分析结果显示,31-40岁、生育意愿、痛经、月经过多、贫血以及头晕乏力是子宫腺肌病患者选择HIFU治疗决策的影响因素。

结论

31-40岁、生育意愿、痛经、月经过多、贫血以及头晕乏力是患者选择HIFU治疗的影响因素。HIFU治疗已成为子宫腺肌病患者替代子宫切除术的一种新选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f68d/9597082/62f94fd8f255/fsurg-09-941368-g001.jpg

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