摘要
目的探讨B超介导下囊肿穿刺术对卵巢子宫内膜异位囊肿(EMA)的诊断价值和术中囊内注入狄波普维拉(DMPA)维持治疗意义。方法对52例临床诊断为卵巢子宫内膜异位囊肿患者在B超下行囊肿穿刺术,观察囊液性状和并作涂片病理检查,对符合卵巢子宫内膜异位囊肿的患者,腔内注入DMPA,并进行随访。结果经穿刺术校正诊断7例,占13.46％。穿刺术使所有患者近期症状缓解,术中加用DMPA可使症状与体征复发率显著减低。对复发病例可行第二次穿刺术,或再加DMPA治疗仍能有效缓解痛经。DMPA的主要副作用可致阴道点滴状出血及停药后排卵恢复慢,用药组中近期无1例受孕。结论B超引导下的囊肿穿刺术,是对卵巢内膜异位囊肿的一种可行的微创性诊断与治疗方法,DMPA囊腔内给药和术后维持治疗能有效地控制症状和促使异位病灶萎缩。
Objective To assess the feasibility of a mini - invasive technique with ultrasound - guided aspiration of adenexal cysts for diagnosis of ovarian endometrioma and injection of Depot medroxyprogesterone acetate (DMPA) for treatment. Methods 52 cases of adnexal cysts were submitted to transabdominal or transvaginal ultrasound - guided aspiration of the cyst content, and if the aspirated fluid were chocolate like, DMPA or alcohol was injected into the empty cyst. The final diagnosis was made according to the characteristics of the aspirated fluid and cytopathology as well. All cases had been followed up more than 12 months.Results Operations were successful in all cases, and no early complications occurred. Diagnoses were corrected in 7cases (13.46%) .After aspiration the symptom and signs of all the patients was improved recently, but some patients had recurrence within 6 months. The group with DMPA present a better control in symptom of dysmenorrhea and the rate of recurrence was lower than that of the group without DMPA. On the recurrent cases, a second aspiration with or without adding DMPA would still have improvement to relieve symptoms. The main side effects of DMPA were irregular bleeding and spotting, and also a depressing ovulation for a long time. In the process of our study, No one got pregnant in the group of with DMPA. Conclusions Ultrasound - guided aspiration of adnexal cyst is a convenient and minimal invasive technique for the diagnosis and therapy of ovarian endometrioma. It is effective to control symptom and to promote atrophy of ectopic endometrium by giving DMPA simultaneously.
出处
《中国妇产科临床杂志》
2001年第5期274-276,共3页
Chinese Journal of Clinical Obstetrics and Gynecology
关键词
子宫内膜异位症
囊肿穿刺术
狄波普维拉
Endometriosis
Aspiration ovarian endometrioma
Depot medroxyprogesterone acetate
