Influencing factors of pain during ultrasound-guided puncture sclerotherapy for ovarian endometriotic cysts
via transabdominal and transvaginal approaches- Journal of Army Medical University Vol. 47, Issue 2, Pages: 186-192(2025)
- 作者机构：
陆军军医大学（第三军医大学）第二附属医院妇产科，重庆
- 作者简介：
XIONG Xi， E-mail： cici0226@163.com
- 基金信息：the Youth Doctoral Talent Incubation Project of the Second Affiliated Hospital of Army Medical University(2022YQB087);the Key Project of Technological Innovation and Application Development of Chongqing(CSTB2022TIAD-KPX0182)
DOI：10.16016/j.2097-0927.202406001
CLC：Published：30 January 2025，
Received：01 June 2024，
Revised：17 July 2024，
- 稿件说明：
移动端阅览
LI YUANHUA, TIAN HONGJU, YANG QIAN, et al. Influencing factors of pain during ultrasound-guided puncture sclerotherapy for ovarian endometriotic cysts
via transabdominal and transvaginal approaches. [J]. Journal of army medical university, 2025, 47(2): 186-192.LI YUANHUA, TIAN HONGJU, YANG QIAN, et al. Influencing factors of pain during ultrasound-guided puncture sclerotherapy for ovarian endometriotic cysts
via transabdominal and transvaginal approaches. [J]. Journal of army medical university, 2025, 47(2): 186-192. DOI： 10.16016/j.2097-0927.202406001.
摘要
目的
2
探讨超声介入穿刺硬化治疗卵巢巧克力囊肿（ovarian endometriotic cysts，OEC）术中疼痛影响因素。
方法
2
采用回顾性队列研究，选取2021年9月至2023年9月在陆军军医大学第二附属医院妇产科接受超声介入穿刺硬化治疗OEC的209例患者为研究对象，收集患者的人口统计学资料、既往病史、手术资料等。按照手术路径分为经腹手术组（
n
=57）和经阴道手术组（
n
=152），在进针、冲洗、置换、硬化和退针5个手术时刻分别进行疼痛评分，分析比较不同手术路径下各手术时刻的疼痛评分情况，对患者疼痛评分最高的进针和置换时刻进行分组，根据疼痛评分将患者分为无/轻度疼痛组（疼痛评分≤3分）和中/重度疼痛组（疼痛评分≥4分），并进行中/重度疼痛发生率的相关因素分析。
结果
2
不同手术路径（经腹/经阴道）的超声介入穿刺硬化治疗OEC对术中疼痛的影响无统计学差异。在进针时，体质量指数（BMI）
>
23.9 kg/m²的患者较BMI≤23.9 kg/m²的患者术中中/重度疼痛发生率高，既往痛经史的患者较无痛经史的患者术中中/重度疼痛发生率高（
P
＜0.05）；在置换时，BMI和既往痛经史与术中中/重度疼痛发生率无相关性。年龄、孕产史、生产方式、初潮时间、经量、盆腔手术史、合并腺肌病史、囊肿大小、手术时长、手术路径对术中置换和进针时疼痛的影响无统计学差异。
结论
2
超声介入穿刺硬化治疗OEC不同手术路径对术中各时刻疼痛无影响，从人文关怀考虑可优先选择经腹穿刺，在进针和置换时刻，对超重和既往痛经史的患者应重点关注，并制定恰当的疼痛干预措施。
Abstract
Objective To investigate the influencing factors of pain during ultrasound-guided puncture sclerotherapy in the treatment of ovarian chocolate cyst (OEC). Methods A retrospective cohort study was conduct
ed on 209 OEC patients undergoing ultrasound-guided puncture sclerotherapy in our department from September 2021 to September 2023. Demographic data
medical history and surgical information were collected. According to surgical approach
they were divided into transabdominal surgery group (
n
=57) and transvaginal surgery group (
n
=152). Pain scores were assessed at 5 surgical time points: needle insertion
irrigation
displacement
sclerosis
and needle withdrawal. Pain scores were compared between the 2 groups at each surgical moment. According to the pain scores at the moments of needle insertion and replacement
the patients were divided into the no/mild pain group (pain score ≤3) and the moderate/severe pain group (pain score ≥4)
and the related factors of the incidence of moderate/severe pain were analyzed. Results There was no statistical difference in intraoperative pain between different surgical approaches (transabdominal/transvaginal) in treating OEC under the guidance of ultrasound. At the moment of needle insertion
significantly higher incidence of moderate/severe pain was observed in the patients with a body mass index (BMI)
>
23.9 kg/m² than those with BMI ≤23.9 kg/m²
and those with a history of dysmenorrhea than those without (
P
<
0.05). At the time point of displacement
BMI and history of dysmenorrhea had no correlation with the incidence of moderate/severe pain. Age
obstetric history
mode of delivery
time of menarche
menstrual volume
history of pelvic surgery
history of combined adenomyosis
size of cysts
duration of surgery
and surgical approach had no notable impacts on intraoperative pain. Conclusion Different surgical approaches for ultrasound-guided puncture sclerotherapy of OEC have no effect on pain levels at various surgical moments. From the aspect of humanistic care
transabdominal puncture should be preferred. During needle insertion and displacement
particular attention should be given to the overweight patients and
those with a history of dysmenorrhea
and appropriate pain intervention measures should be formulated.
关键词
超声介入卵巢巧克力囊肿疼痛影响因素
Keywords
ultrasound-guided interventionovarian chocolate cystpaininfluencing factors
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