CT引导下经皮穿刺置管硬化治疗卵巢巧克力囊肿的临床疗效分析

doi:10.3877/cma.j.issn.2095-5782.2022.04.009

目的

探讨CT引导下经皮穿刺置管硬化治疗卵巢巧克力囊肿的临床疗效与安全性。

方法

回顾性分析51例卵巢巧克力囊肿患者资料，其中8例经前腹壁穿刺置管，43例经臀部穿刺置管，随后经引流管注入聚桂醇泡沫硬化剂硬化治疗巧克力囊肿，分析治疗前后巧克力囊肿最大径、糖类抗原125（CA125）、抗缪勒管激素（AMH）变化情况及术后并发症情况。

结果

51例患者的整体有效率为98.0%。患者术后3、6个月的囊肿最大径均较术前显著性缩小（P值均< 0.001）；CA125水平均较术前显著性降低（P值均< 0.001）。患者术后6个月与术前、术后3个月的AMH水平差异均无统计学意义（P = 0.421，0.182）。无相关严重手术并发症出现。

结论

CT引导下经皮穿刺置管硬化治疗卵巢巧克力囊肿安全、有效，可作为较大（直径≥4 cm）卵巢巧克力囊肿的替代治疗方案。

关键词: CT, 卵巢巧克力囊肿, 硬化治疗, 疗效分析

Objective

To assessed the clinical effectiveness and safety of CT-guided percutaneous catheter-directed sclerotherapy (CDS) with lauromacrogol foam for ovarian endometriomas (OEM).

Methods

Of the 51 patients who underwent CDS for OEM were retrospectively analyzed, eight cases were punctured from the anterolateral abdominal wall, while 43 cases were punctured from buttock. Subsequently, lauromacrogol foam was injected into the cyst of OEM. Cyst size, serum cancer antigen 125 (CA-125), and serum anti-Müllerian hormone (AMH) levels were compared before and after the procedure. Operational complications were reviewed.

Results

The overall disease control rate of 51 patients was 98.0%. The mean size of cysts significantly decreased from before to after 3-months and 6-months of sclerotherapy (both P < 0.001). CA125 levels declined significantly from before to after 3-months and 6-months of sclerotherapy (both P < 0.001). There was no statistically significant difference between the after 6-months and preoperative or after 3-months of sclerotherapy AMH levels (P = 0.421, P = 0.182, respectively). There were no procedure-related seriously complications.

Conclusions

CT-guided percutaneous CDS for OEM is a safe, effective alternative to surgical intervention for treatment part of large diameter (≥4 cm) OEM.

Key words: CT, Sclerotherapy, Endometriosis, Efficacy

表1 51例卵巢巧克力囊肿基线情况

参数	未婚组（39例）	已婚组（12例）	P值
年龄（岁）	20~36（27）	22~38（27）	0.647
单侧囊肿（例）	28	6	0.166
双侧囊肿（例）	11	6
术前囊肿最大径（cm）	7.58 ± 2.65	5.97 ± 1.29	0.032
术前AMH（ng/mL）	2.98 ± 1.43	2.63 ± 2.04	0.230
术前CA125（U/mL）	80.06 ± 70.46	98.30 ± 111.95	0.965

表1 51例卵巢巧克力囊肿基线情况

参数	未婚组（39例）	已婚组（12例）	P值
年龄（岁）	20~36（27）	22~38（27）	0.647
单侧囊肿（例）	28	6	0.166
双侧囊肿（例）	11	6
术前囊肿最大径（cm）	7.58 ± 2.65	5.97 ± 1.29	0.032
术前AMH（ng/mL）	2.98 ± 1.43	2.63 ± 2.04	0.230
术前CA125（U/mL）	80.06 ± 70.46	98.30 ± 111.95	0.965

图1 CT引导下卵巢巧克力囊肿穿刺硬化治疗1A、1B：为经前腹壁穿刺置管硬化治疗前后；1C、1D：为经臀部穿刺置管硬化治疗前后

表2 51例患者治疗前后疗效指标变化情况

疗效指标	术前	术后3个月	术后6个月	P值*	P值**	P值***
囊肿最大径（cm）	7.20 ± 2.48	1.47 ± 1.73	1.44 ± 1.63	< 0.001	< 0.001	0.153
CA125（U/mL）	84.35 ± 81.19	24.10 ± 23.89	22.65 ± 19.48	< 0.001	< 0.001	0.705
AMH（ng/mL）	2.90 ± 1.58	2.30 ± 1.42	2.57 ± 1.42	0.028	0.421	0.182

表2 51例患者治疗前后疗效指标变化情况

疗效指标	术前	术后3个月	术后6个月	P值*	P值**	P值***
囊肿最大径（cm）	7.20 ± 2.48	1.47 ± 1.73	1.44 ± 1.63	< 0.001	< 0.001	0.153
CA125（U/mL）	84.35 ± 81.19	24.10 ± 23.89	22.65 ± 19.48	< 0.001	< 0.001	0.705
AMH（ng/mL）	2.90 ± 1.58	2.30 ± 1.42	2.57 ± 1.42	0.028	0.421	0.182

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Clinical effectiveness analysis of CT-guided percutaneous catheter-directed sclerotherapy for ovarian endometriomas

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Clinical effectiveness analysis of CT-guided percutaneous catheter-directed sclerotherapy for ovarian endometriomas