本文選題：宮頸炎癥相關(guān)疾病 + 聚焦超聲治療�。� 參考：《重慶醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的:通過(guò)宮頸炎癥相關(guān)疾病的聚焦超聲治療臨床隨機(jī)對(duì)照研究,對(duì)比觀察聚焦超聲與射頻治療后宮頸的轉(zhuǎn)歸情況，同時(shí)行安全性、有效性、經(jīng)濟(jì)性、適用性評(píng)估，獲得一個(gè)適用于農(nóng)村基層推廣的聚焦超聲治療新方案。 方法:按隨機(jī)表產(chǎn)生的隨機(jī)數(shù)字將受試者隨機(jī)分配到聚集超聲組和射頻組，每組各100例患者。通過(guò)治療后2周、4周、3月、6月、12個(gè)月隨訪觀察，對(duì)比分析聚焦超聲與射頻治療的安全性、有效性、經(jīng)濟(jì)性及適用性。 結(jié)果：1)不良反應(yīng)：聚焦超聲組術(shù)后陰道中等排液發(fā)生率低于射頻組,且術(shù)后排液持續(xù)時(shí)間在16～20天的發(fā)生率明顯低于射頻組（P均0.05）。聚焦超聲組術(shù)后陰道流血需臨床干預(yù)的病例數(shù)明顯少于射頻組，且因術(shù)后急1性感染出血的病例數(shù)也少于射頻組（P均0.05）。2)臨床療效研究結(jié)果顯示：聚焦超聲組為98.89%，射頻組為98.90%，，兩組療效結(jié)果比較無(wú)明顯統(tǒng)計(jì)學(xué)差異（P0.05）。SF-36健康調(diào)查量表評(píng)分結(jié)果顯示：聚焦超聲組與射頻組治療前SF-36量表的8個(gè)維度、總體生理健康（Total physical health, TPH）及總體心理健康（Total mentalhealth,TMH）的評(píng)分比較無(wú)統(tǒng)計(jì)學(xué)差異(P均0.05)。治療后隨訪6個(gè)月，聚焦超聲組術(shù)前、術(shù)后SF-36健康調(diào)查量表8個(gè)維度、TPH及TMH得分的差值與射頻組術(shù)前、術(shù)后的得分差值進(jìn)行比較，在活力（Vitality,VT）、情感職能（Emotional limitations, RE）、精神健康（Mentalhealth, MH）及TMH方面的得分差值均高于射頻組，統(tǒng)計(jì)學(xué)差異明顯（P均0.05）。3）經(jīng)濟(jì)學(xué)分析：術(shù)前兩組各項(xiàng)費(fèi)用比較無(wú)明顯統(tǒng)計(jì)學(xué)差異(P均0.05)。治療后副反應(yīng)陰道流血臨床干預(yù)在檢查費(fèi)、處置費(fèi)兩組差異無(wú)統(tǒng)計(jì)學(xué)意義（P均0.05），而藥物費(fèi)、總費(fèi)用兩組比較統(tǒng)計(jì)學(xué)差異明顯（P均0.05）。本研究對(duì)術(shù)后隨訪6個(gè)月的各項(xiàng)費(fèi)用的總成本分析結(jié)果顯示：藥物費(fèi)、檢查費(fèi)及總費(fèi)用上兩組統(tǒng)計(jì)學(xué)差異明顯（P均＜0.01），余費(fèi)用兩組比較無(wú)統(tǒng)計(jì)學(xué)差異（P均＞0.05）。聚集超聲組人均治療總費(fèi)用1144.74元，射頻組人均治療總費(fèi)用1244.55元，成本-效果比(C/E)聚焦超聲組（11.58）少于射頻組（12.58）；進(jìn)行敏感性分析，假設(shè)檢查費(fèi)提高10%、藥物費(fèi)降低10%，兩組成本-效果比(C/E)聚焦超聲組（11.66）少于射頻組（12.58）。4）適用性評(píng)價(jià):醫(yī)生和患者的滿意度評(píng)價(jià)兩組結(jié)果未見(jiàn)明顯統(tǒng)計(jì)學(xué)差異（P均＞0.05）。 結(jié)論：聚焦超聲與射頻治療宮頸炎癥相關(guān)疾病療效相當(dāng)，但聚焦超聲治療可顯著改善患者術(shù)后的生存質(zhì)量，不良反應(yīng)發(fā)生率低，經(jīng)濟(jì)、適用可在農(nóng)村推廣使用。
[Abstract]:Objective: to observe the outcome of focused ultrasound and radiofrequency ultrasound in the treatment of cervical inflammation related diseases, and to evaluate the safety, effectiveness, economy and applicability of the treatment. A new scheme of focused ultrasound treatment for rural grass-roots extension was obtained. Methods: the subjects were randomly assigned to the group of aggregated ultrasound and the group of radio frequency according to the random numbers generated by random table, with 100 patients in each group. After 2 weeks, 3 months, 6 months and 12 months of follow-up, the safety and efficacy of focused ultrasound and radiofrequency therapy were compared and analyzed. Results: the incidence of moderate vaginal effusion in focused ultrasound group was lower than that in radio frequency group, and the incidence of postoperative drainage duration in 1620 days was significantly lower than that in radio frequency group (P < 0.05). The number of patients with postoperative vaginal bleeding in focused ultrasound group was significantly less than that in radiofrequency group. And the number of patients with acute first infection bleeding after operation was also less than that of radiofrequency group (P < 0.05).) the results showed that: focused ultrasound group was 98.89 and radiofrequency group 98.90. There was no significant difference between the two groups in the curative effect of the two groups (P0.05SF-36 health survey scale). The results showed that the SF-36 scale had 8 dimensions before treatment in focused ultrasound group and radiofrequency group. There was no significant difference in total physical health (TPHs) and total mental health (THs) scores between the two groups (P < 0.05). After 6 months follow-up, the differences of TPH and TMH scores in 8 dimensions of SF-36 health survey scale were compared with those in radiofrequency group before and after operation. The difference of scores in Vitality, emotional function, mental health, mental health and TMH were higher than that in radio frequency group (P < 0.05). Economic analysis showed that there was no significant difference between the two groups before operation (P < 0.05). There was no significant difference between the two groups in the examination fee and the disposal cost after treatment, but there was significant difference in the drug cost and the total cost between the two groups (P < 0.05). The results of the total cost analysis of the six months follow-up showed that the two groups had significant statistical differences in drug cost, examination fee and total cost (P < 0.01), but there was no significant difference in the remaining cost between the two groups (P > 0.05). The total cost per person in the focused ultrasound group was 1144.74 yuan, and that in the radiofrequency group was 1244.55 yuan, which was lower than that in the C / E focused ultrasound group (11.58%), and the sensitivity analysis was performed. Assuming that the examination fee was increased by 10%, the drug cost was reduced by 10%, the cost-effectiveness of the two groups was lower than that of the C / E focused ultrasound group (11.66) was less than that of the radiofrequency group (12.58 渭 g 路.4): there was no significant difference between the two groups in the evaluation of doctor's and patient's satisfaction (P > 0.05). Conclusion: there is no significant difference between the two groups in the evaluation of doctor's and patient's satisfaction (P > 0.05). The therapeutic effects of focused ultrasound and radiofrequency on cervix inflammation related diseases are equivalent. But the treatment of focused ultrasound can significantly improve the quality of life of patients after operation, the incidence of adverse reactions is low, economic, applicable in rural areas.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R711.32

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