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目的观察高强度聚焦超声治疗外阴上皮内非瘤样病变的临床疗效及对患者性生活质量的影响。方法选择2008年3月至2011年11月,于我院经外阴多点活检病理证实为外阴上皮内非瘤样病变者198例,随机分为超声聚焦治疗组(n=102)和药物+微波治疗组(n=96)。超声组采用高强度聚焦超声连续直线扫描,治疗功率3.5W,时间20～30分,药物+微波组选用我院自制的复方白斑膏加传统微波治疗。治疗前及疗程结束6个月外阴多点活检,进行疗效评估。治疗前后分别采用女性性功能指标量表(Female Sexual Function Index,FSFI)对患者性功能进行评价。结果治疗后6个月,根据临床评分表,对病损部位皮肤弹性、色泽、病损范围占外阴部的百分比进行综合评价。超声组治愈35例(34.3%),显效63例(61.8%),无效4例(3.9%),有效率为96.1%(98/102)。药物+微波组96例,治愈5例(5.2%),显效56例(58.3%),无效35例(36.5%),有效率为63.5%(61/96)。二者比较差异有统计学意义。术后6月两组患者性生活评分有统计学差异(P<0.01)。结论聚焦超声治疗具有安全、有效、无创的特点,能有效改善患者性生活障碍。是治疗外阴上皮内非瘤样病变的有效手段。
Objective To observe the clinical effect of high intensity focused ultrasound on intravaginal intraepithelial neoplasia and its influence on the quality of life of patients. Methods From March 2008 to November 2011, 198 cases of non-vulvar intra-vulvar intraepithelial neoplasia confirmed by multiple genital biopsy in our hospital were randomly divided into ultrasound focus treatment group (n = 102) and drug + microwave Treatment group (n = 96). Ultrasound group using high-intensity focused ultrasound continuous linear scan, the treatment power 3.5W, time 20 to 30 minutes, drug + microwave group selected our hospital homemade compound cream and traditional microwave treatment. 6 months before treatment and end of the course of the vulva multi-biopsy for efficacy evaluation. Before and after treatment, the female sexual function index (FSFI) was used to evaluate the sexual function. Results Six months after treatment, according to the clinical score table, the percentage of skin elasticity, color and lesion area in the lesion area to the vulva area was evaluated comprehensively. In the ultrasound group, 35 cases (34.3%) were cured, 63 (61.8%) were markedly effective, 4 (3.9%) were ineffective, and the effective rate was 96.1% (98/102). 96 cases were treated with drug + microwave, 5 cases were cured (5.2%), 56 cases (58.3%) were cured, 35 cases (36.5%) were ineffective, and the effective rate was 63.5% (61/96). The difference between the two was statistically significant. There was a significant difference in sexual life between the two groups after 6 months (P <0.01). Conclusions Focused ultrasound is safe, effective and noninvasive, which can effectively improve the sexual life disorder in patients. It is an effective method to treat non-tumorous lesions in vulvar epithelium.