Efficacy Analysis Of Chymotrypsin Combined With Different Sclerosing Agents On Ovarian Endometriosis Cysts

Objective:To explore the clinical value of sclerotherapy on ovarian endometriosis cysts(OEC)using chymotrypsin combined with anhydrous ethanol and polucinnamol under ultrasound guidance.Method:This is a retrospective study,patients who underwent ultrasound-guided sclerotherapy and were diagnosed with OEC after cystic fluid pathology from January 2007 to December 2018 were randomly selected.A total of 90 patients were admitted to the First People’s Hospital of Wujiang District,Suzhou City or Yongding Hospital of Wujiang District,Suzhou City,and 90 cysts were enrolled in the OEC.OEC sclerotherapy was divided into three groups:there were 30 cases in anhydrous ethanol group;31 cases in double sclerosis group(anhydrous ethanol combined with polucinnamol);29 cases in combination group(chymotrypsin combined with anhydrous ethanol and polucinnamol).The incidence of adverse reactions during and after the treatment(within twelve hours)was recorded,and the differences among the three groups were analyzed;all subjects were examined by ultrasound follow-up one week before the treatment,six months and twelve months after the treatment,and the efficacy(inefficiency,efficiency and cure rate)at each time point was recorded;the difference of efficacy among the three groups was explored,and the possible factors affecting the efficacy of twelve months after the treatment were analyzed.Result:1.The total incidence of adverse reactions during and after treatment(within twelve hours)were 33.33%,9.68%and 13.79%in anhydrous ethanol group,double sclerosis group and combination group.There was no statistical significance in the total incidence of adverse reactions during and after treatment(within twelve hours)between the latter two groups(P>0.05);there was statistical significance in the total incidence of adverse reactions during and after treatment(within twelve hours)between the anhydrous ethanol group and the other two groups(P<0.05);there was no statistical significance in adverse reactions at other time points.2.Six months after treatment,the efficacy(inefficiency,efficiency and cure rate)were 13.3%,10.0%and 76.7%in the anhydrous ethanol group,16.1%,6.5%and 77.4%in the double sclerosis group,10.3%,0.0%and 89.7%in the combined group.There was no statistical significance in the efficacy among the three groups(P>0.05).3.Twelve months after treatment,the efficacy(inefficiency,efficiency and cure rate)were 30.0%,20.0%and 50.0%in the anhydrous ethanol group,29.0%,19.4%and 51.6%in the double sclerosis group,13.8%,10.3%and 75.9%in the combined group.There was no statistical significance in the efficacy between the anhydrous ethanol group and the double sclerosis group(P>0.05);there was statistical significance in the efficacy between the combined group and the other two groups(P<0.05).4.Twelve months after treatment,the cystic wall thickness,the cyst fluid transfusion,and the residual mass after treatment(with/without)are the important possible factors affecting the efficacy in the absolute ethanol group and the double sclerosis group.The residual mass after treatment(with/without)is an important possible factor affecting the efficacy in the combined group.Conclusion:1.Under the guidance of ultrasound,chymotrypsin combined with anhydrous ethanol and polucinnamol sclerotherapy has less adverse reactions and better therapeutic effect on OEC.2.Anhydrous ethanol,anhydrous ethanol combined with polucinnamol sclerotherapy for OEC with cystic wall thickness,cyst fluid transfusion difficulty and residual mass after treatment have poor curative effect.Chymotrypsin combined with anhydrous ethanol and polucinnamol sclerotherapy can improve the efficacy of OEC with cystic wall thickness and cyst fluid transfusion difficulty;however the efficacy of OEC with residual mass after treatment has not been significantly improved.