Multiple Factors Analysis Of Recurrence Rate For Interventional Ultrasound Treatment For Ovarian Endometrial Cysts

Objective:Through visiting the patients with interventional ultrasound treatment for ovarian endometrial cysts and retrospectively analyzing multiple factors for recur-rence rate.Methods:Choose the patients in the first affiliated hospital of kunming medical univisity of gynecology, combining with the history, examination of department of gynecology, ultrasound, and serum tumor markers detection, clinical diagnosis of ovarian endometrial cysts of outpatient and inpatient as the research object from June2011to Apirl2014. Ovarian endometrial cysts were transvaginal or abdominal ultrasound-guided punctured and aspirated obsolete blood until the cysts nearly empty.Dilute the fluid with normal saline and vitamin C, if it is hard to aspirate.Then injected anhydrous ethanol to flush the walls of cysts and kept alcohol in the cysts.After operation, give GnRH-a(goserelin)treatment for three cycles.All the cases were follow-up after3moth,6moth,12moth,24moth of the operation and observed treatment effect. The evaluating standards of the completely cured rate and recurrence rate as follows:(1)Completely cured:the cysts disappears or the remanent cyst no increased.(2)Recurrence:the completely cured cyst recurrence or the remanent cyst enlarged. All the patients clinical interviewed, did physical examination and ultrasonography. The factors measured included:age at surgery,serum CA125, history of operation for endometriosis(yes or no), side of endometrial cyst(left/right/bilateral), size of cyst, thickness of cyst, multilocular or monolocular cyst, time of using alcohol in operation,using GnRH-a after operation or not, residual cyst or not. The recurrent rate and its predictive factors were evaluated and the multivariate logistic regression to determinate the predictive factors for recurrence of endometriosis.Results:There are38patients treated by ultrasound-guided puncture for ovarian endometrial cysts between June2011to April2014. Age is33.5±6.6years old.After6moth, the Ultrasonic examination results were as follows:34cases were cured,4cases of recurrence, the cure rate was89.5%, the recurrence rate is10.5%;After24moth, the Ultrasonic examination results were as follows:25cases were cured,13cases of recurrence, the cure rate was66%, the recurrence rate was34%. When the logistic regression partial regression coefficient is positive, the OR value is greater than1, shows that the factors are risk factors. The partial regression coefficient is negative, the OR value is less than1, the factors are protective factors.The related factors and their odds ratio(OR) by multivariable analysis after6moth were as follows:patients’ age. residual cyst or not, the thickness of cyst were into the model, the OR value is greater than1,they are risk factors. Meanwhile,used of postoperative GnRH-a,the OR value is less than1, it was protective factor. The related factors and their odds ratio(OR) by multivariable analysis after24moth were as follows:patients’ age, side of cyst, the thickness of cyst were into the model, the OR value is greater than1, they were risk factors. Meanwhile,used of postoperative GnRH-a, the OR value is less than1, it was protective factor. Postoperative recurrence rate after3moth,6moth,12moth,24moth did x2test(P<0.05), the subject study shows postoperative recurrence rate increases with time extend.Conclusions:The risks for short-term recurrence of ultrasound-guided puncture endometrial cysts include Age of patients,Thickness of cyst,The residual of cyst Whereas the protective factors include used GnRH-a after operation. The risk factors for mid-term recurrence of ultrasound-guided puncture endometrial cyst include:Age of patients, Thickness of cyst, The side of cyst. Whereas the protective factors include used GnRH-a after operation. At the same time, the subject study shows Postoperative recurrence rate increases with time extend,short-term curative effect is better. The treatment remove the cyst in short time, the effect is exact and fast. For patients with recurrence after surgery can be repeatedly targeted therapy. It can reduce patients’ pain, it is a safe, simple, minimally invasive and effective method.