질식 고주파 자궁근종용해술을 이용한 자궁평활근종 및 자궁선근증의 보존적 치료에 대한 효과의 비교분석 Comparative analysis on the effectiveness of transvaginal radiofrequency myolysis for conservative management of Leiomyoma and adenomyosis
목 적 : 자궁평활근종 환자들과 임상증상 및 치료가 비슷한 자궁선근증 환자들의 질식 고주파 자궁근종용해술의 임상효과에 대하여 비교하고자 한다. 방 법 : 2005년 5월부터 2006년 5월까지 본원에서 자궁평활근종과 자궁선근증으로 진단 받은 총 108명을 대상으로 질식 고주파 자궁근종용해술을 시행하였다. 시술 전, 후 초음파를 이용하여 평활근종과 선근증의 크기, 개수, 위치 그리고 부피를 측정하였으며, 시술 후 매 방문마다 증상과 삶의 질에 대한 질문표를 사용해 호전 유무를 추적, 관찰하였다. 통계학적 유의성을 알아보기 위해 Wilcoxon signed rank test (SPSS 13.0)를 이용하였고 P값이 0.05 미만인 경우를 의미있다고 판정하였다. 결 과 : 질식 고주파 근종용해술을 시행 받은 76명의 평활근종 환자에서 평균 최대직경은 시술 후 1개월, 3개월, 6개월, 9개월에 각각 14.6%, 23.3%, 30.6%, 33.6%의 감소율과, 평균 부피는 각각 35.7%, 53.3%, 67.3%, 72.2%의 감소를 보였다. 또한 32명의 선근증 환자에서도 평균 최대직경은 시술 후 각각 8.9%, 13.6%, 14.6%, 11.9%의 감소 과, 평균 부피는 각각 22.6%, 30.0%, 32.3%, 28.4%의 감소를 보였다. 평활근종의 경우 증상의 중증도 (Symptom score)는 시술 전, 시술 후 각각 62.3, 52.2, 40.6, 32.6, 28.6이었고, 삶의 질 (QOL score)은 각각 68.9, 78.1, 82.9, 85.7, 87.3이었다. 선근증의 경우 증상의 중증도는 각각 77.7, 37.6, 30.6, 54.4, 67.5였고, 삶의 질은 각각 48.1, 76.5, 85.5, 66.5, 55.1이었다. 결 론 : 질식 고주파 자궁근종용해술은 자궁을 보존할 수 있고 비침습적이며, 근종의 크기 및 증상의 감소에 효과가 있고 바로 일상생활로의 복귀가 가능하다는 장점이 있다. 그러나 자궁선근증은 시술 후 약 6-9개월 이후 증상이 재발되는 경향을 보여 추가적인 연구 및 추적관찰을 통해 엄격한 적용기준이 마련되어야 할 것이다.
목 적 : 자궁평활근종 환자들과 임상증상 및 치료가 비슷한 자궁선근증 환자들의 질식 고주파 자궁근종용해술의 임상효과에 대하여 비교하고자 한다. 방 법 : 2005년 5월부터 2006년 5월까지 본원에서 자궁평활근종과 자궁선근증으로 진단 받은 총 108명을 대상으로 질식 고주파 자궁근종용해술을 시행하였다. 시술 전, 후 초음파를 이용하여 평활근종과 선근증의 크기, 개수, 위치 그리고 부피를 측정하였으며, 시술 후 매 방문마다 증상과 삶의 질에 대한 질문표를 사용해 호전 유무를 추적, 관찰하였다. 통계학적 유의성을 알아보기 위해 Wilcoxon signed rank test (SPSS 13.0)를 이용하였고 P값이 0.05 미만인 경우를 의미있다고 판정하였다. 결 과 : 질식 고주파 근종용해술을 시행 받은 76명의 평활근종 환자에서 평균 최대직경은 시술 후 1개월, 3개월, 6개월, 9개월에 각각 14.6%, 23.3%, 30.6%, 33.6%의 감소율과, 평균 부피는 각각 35.7%, 53.3%, 67.3%, 72.2%의 감소를 보였다. 또한 32명의 선근증 환자에서도 평균 최대직경은 시술 후 각각 8.9%, 13.6%, 14.6%, 11.9%의 감소 과, 평균 부피는 각각 22.6%, 30.0%, 32.3%, 28.4%의 감소를 보였다. 평활근종의 경우 증상의 중증도 (Symptom score)는 시술 전, 시술 후 각각 62.3, 52.2, 40.6, 32.6, 28.6이었고, 삶의 질 (QOL score)은 각각 68.9, 78.1, 82.9, 85.7, 87.3이었다. 선근증의 경우 증상의 중증도는 각각 77.7, 37.6, 30.6, 54.4, 67.5였고, 삶의 질은 각각 48.1, 76.5, 85.5, 66.5, 55.1이었다. 결 론 : 질식 고주파 자궁근종용해술은 자궁을 보존할 수 있고 비침습적이며, 근종의 크기 및 증상의 감소에 효과가 있고 바로 일상생활로의 복귀가 가능하다는 장점이 있다. 그러나 자궁선근증은 시술 후 약 6-9개월 이후 증상이 재발되는 경향을 보여 추가적인 연구 및 추적관찰을 통해 엄격한 적용기준이 마련되어야 할 것이다.
Objective : To compare the clinical effectiveness of transvaginal radiofrequency myolysis of the patients with leiomyomas and the patients with adenomyosis which have similar clinical symptoms. Methods : From May 2005 to May 2006 at Eulji university hospital, 108 women who were diagnosed of leiomyom...
Objective : To compare the clinical effectiveness of transvaginal radiofrequency myolysis of the patients with leiomyomas and the patients with adenomyosis which have similar clinical symptoms. Methods : From May 2005 to May 2006 at Eulji university hospital, 108 women who were diagnosed of leiomyoma and adenomyosis had undergone transvaginal radiofrequency myolysis. Before and after the procedure size, number of uterine myomas, location and the volume of the leiomyomas and adenomyosis were measured by ultrasound. And on every visit after the procedure improvement of the symptom was checked by questionnaire of the symptom and life quality. Using Wilcoxon signed ranked test, the statistical significance was proved and the P value lower than 0.05 was judged to be significant. Results : 76 women with leiomyoma who had undergone transvaginal radiofrequency myolysis, were followed up 1 month, 3 months, 6 months and 9 months after the procedure. The average maximal diameter of the myoma was decreased by 14.6%, 23.3%, 30.6%, 33.6% respectively, and the average volume was decreased by 35.7%, 53.3%, 67.3%, 72.2% respectively. 32 women with adenomyosis who had undergone transvaginal radiofrequency myolysis were followed up, at the same period after the procedure. The average maximal diameter of the adenomyosis was decreased by 8.9%, 13.6%, 14.6%, 11.9% respectively, and the average volume was decreased by 22.6%, 30.0%, 32.3%, 28.4% respectively. Before and after the procedure the symptom score was 62.3, 52.2, 40.6, 32.6, 28.6 respectively, and the quality of life score was 68.9, 78.1, 82.9, 85.7, 87.3 respectively in the leiomyoma group. In the adenomyosis group, before and after the procedure the symptom score was 77.7, 37.6, 30.6, 54.4, 67.5 respectively, and the quality of life score was 48.1, 76.5, 85.5, 66.5, 55.1 respectively. Conclusion : Transvaginal radiofrequent myolysis had benefits in conserving the uterus, and was less invasive, and had great effect on the reducing the size of the leiomyoma and improving the symptoms, and also returning to normal life pattern was earlier. But in women with adenomyosis the symptoms were worsened after approximately 6 to 9 months after the procedure. Therefore additional research and follow-up is required and a strict criterion is needed.
Objective : To compare the clinical effectiveness of transvaginal radiofrequency myolysis of the patients with leiomyomas and the patients with adenomyosis which have similar clinical symptoms. Methods : From May 2005 to May 2006 at Eulji university hospital, 108 women who were diagnosed of leiomyoma and adenomyosis had undergone transvaginal radiofrequency myolysis. Before and after the procedure size, number of uterine myomas, location and the volume of the leiomyomas and adenomyosis were measured by ultrasound. And on every visit after the procedure improvement of the symptom was checked by questionnaire of the symptom and life quality. Using Wilcoxon signed ranked test, the statistical significance was proved and the P value lower than 0.05 was judged to be significant. Results : 76 women with leiomyoma who had undergone transvaginal radiofrequency myolysis, were followed up 1 month, 3 months, 6 months and 9 months after the procedure. The average maximal diameter of the myoma was decreased by 14.6%, 23.3%, 30.6%, 33.6% respectively, and the average volume was decreased by 35.7%, 53.3%, 67.3%, 72.2% respectively. 32 women with adenomyosis who had undergone transvaginal radiofrequency myolysis were followed up, at the same period after the procedure. The average maximal diameter of the adenomyosis was decreased by 8.9%, 13.6%, 14.6%, 11.9% respectively, and the average volume was decreased by 22.6%, 30.0%, 32.3%, 28.4% respectively. Before and after the procedure the symptom score was 62.3, 52.2, 40.6, 32.6, 28.6 respectively, and the quality of life score was 68.9, 78.1, 82.9, 85.7, 87.3 respectively in the leiomyoma group. In the adenomyosis group, before and after the procedure the symptom score was 77.7, 37.6, 30.6, 54.4, 67.5 respectively, and the quality of life score was 48.1, 76.5, 85.5, 66.5, 55.1 respectively. Conclusion : Transvaginal radiofrequent myolysis had benefits in conserving the uterus, and was less invasive, and had great effect on the reducing the size of the leiomyoma and improving the symptoms, and also returning to normal life pattern was earlier. But in women with adenomyosis the symptoms were worsened after approximately 6 to 9 months after the procedure. Therefore additional research and follow-up is required and a strict criterion is needed.
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