| Objective: Being a minimally invasive treatment with advantages like convenient, safe, minimally invasive and low costs, the medication injection into fibroid under the ultrasonic guidance has become a surgical method recognized by patients. Although there are quite a number of drugs for injecting treatment of fibroid under ultrasonic guidance, the comparative study on treatment effect of different drugs on the same organism hasn’t been available while the comparative study on different organisms lacks of persuasion for their different internal environment. This paper adopts excised human fibroid injected with different drugs under ultrasonic guidance, compares their treatment effect and provides experimental basis for clinical treatment of fibroid by drug injection under ultrasonic guidance.Method: Collect and screen 70 fibroid specimens in total out of hysteromyoma patients from Obstetrics and Gynecology Department of the Second Municipal Hospital dating from January 2013 to December 2014.Multiple myoma group are injected 1ml absolute ethyl alcohol, high- temperature normal saline and high-temperature hypertonic saline respectively. We observe and measure changes in the instant ultrasonoscopy and diffusion ranges,and record the resistance felt and drug diffusion velocity in injection process; when injected doses reach 2ml, measure and record again. Single myoma group are injected 1ml and 2ml absolute ethyl alcohol, high- temperature normal saline and high-temperature hypertonic saline from different directions respectively. We observe and measure changes in instant ultrasonoscopy and diffusion ranges in injection against different drugs into the same fibroid, and record the resistance felt and drug diffusion velocity in injection process. After withdrawing of the needle, mark injecting point for pathological sampling. Track diffusion ranges and changes in ultrasonoscopy after 0.5 hour, 1 hour and 24 hours. All specimens are sent to pathological test for observing and comparing status of cell necrosis.Adopt medical statistical software SPSS17.0 for statistical and analytical treatment of various materials, where measurement data is indicated as mean value ± standard deviation(X±s). Comparison between the two groups uses t test; More than three group and three group comparison between groups uses ANOVA, P<0.05 with statistical significance.Results: 1 Multiple myoma group: inject absolute ethyl alcohol, high-temperature normal saline and high-temperature hypertonic saline respectively, and observe instant diffusion range: 1.1 Inject 1ml, observe diffusion range, diffusion ranges of absolute ethyl alcohol0.80±0.08 cm, diffusion ranges of high-temperature normal saline 0.62±0.07 cm, diffusion ranges of high-temperature hypertonic saline 0.72±0.07 cm,find the three groups’ comparisons with statistical differences, P<0.05; Diffusion ranges of absolute ethyl alcohol are wider than high-temperature hypertonic saline, and diffusion ranges of high-temperature hypertonic saline are wider than high-temperature normal saline groups.Inject 2ml, observe diffusion ranges, diffusion ranges of absolute ethyl alcohol 1.31±0.12 cm,diffusion ranges of high-temperature normal saline 1.05±0.11 cm,diffusion ranges of high-temperature hypertonic saline 1.22±0.11 cm,found comparisons of the three groups with statistical differences, P<0.05; Compare absolute ethyl alcohol, high-temperature hypertonic saline and high-temperature normal saline groups, with statistical differences; for the rest, no statistical difference. 1.2 For the same sclerosing agent, when the dose injected reaches 2ml, the diffusion range will have obvious statistical difference from that of 1ml, P<0.05. 2. Single fibroid group 2.1 Absolute Ethyl Alcohol GroupInject 1ml and observe, compare diffusion ranges of instant hour, 0.5 hour, 1 hour and 24 hours, 0.77±0.10cm、0.75±0.12cm、0.71±0.12cm、0.65±0.12 cm,with statistical difference, P<0.05; comparison of diffusion ranges of 24 hours and instant hour, with statistical difference; for the rest, no statistical difference.Inject 2ml and observe, compare diffusion ranges of instant hour, 0.5 hour, 1 hour and 24 hours, 1.24±0.09cm、1.20±0.12cm、1.16±0.13cm、1.11±0.14 cm,without statistical difference, P>0.05.Inject 2ml compare with those of instant hour, 0.5 hour, 1 hour and 24 hours, of 1ml, with statistical difference, P<0.05.1 hour ultrasonoscopy indicates that the diffusion range is slightly better defined than that of instant injection. 24 hour diffusion range edge is well defined, and the internal echo is unevenly strong. Pathological findings indicate massive meronecrobiosis of smooth muscle cells, even staining with light pink, visible destroyed vascular wall and various degrees of blood embolisms in blood vessels. 2.2 High-temperature normal salineInject 1ml and observe, compare diffusion ranges of instant hour, 0.5 hour, 1 hour and 24 hours, 0.60±0.07cm、0.60±0.08cm、0.55±0.08cm、0.51±0.09 cm,with statistical difference, P<0.05; comparisons of diffusion ranges of 24 hours, instant hour and 30 minutes, with statistical difference; for the rest, no statistical difference.Inject 2ml and observe, compare diffusion ranges of instant hour, 0.5 hour, 1 hour and 24 hours, 0.94±0.09cm、0.91±0.08cm、0.89±0.08cm、0.83±0.10 cm,without statistical difference, P>0.05.Inject 2ml compare with those of instant hour, 0.5 hour, 1 hour and 24 hours, of 1ml, all with statistical difference, P<0.05.1 hour ultrasonoscopy indicates that diffusion range is slightly better defined than that of instant injection. 24 hour diffusion range edge is well defined, and the internal echo is unevenly strong. Pathological findings indicate light pink staining, lack of evenness, smooth muscle cells and cell nucleus edema and partially destroyed blood vessels visible. 2.3 High-temperature hypertonic salineInject 1ml and observe, compare diffusion ranges of instant hour, 0.5 hour, 1 hour and 24 hours, 0.77±0.08cm、0.74±0.08cm、0.68±0.11cm、0.66±0.12 cm,with statistical difference, P<0.05; compare diffusion ranges of 1 hour and 24 hours, with statistical difference; for the rest, no statistical difference.Inject 2ml and observe, compare diffusion ranges of instant hour, 0.5 hour, 1 hour and 24 hours, 1.25±0.18cm、1.21±0.16cm、1.20±0.13cm、1.11±0.16 cm,without statistical difference, P>0.05.Inject 2ml, compare with instant hour, 0.5 hour, 1 hour and 24 hours of 1ml, with statistical differences, P<0.05.1 hour ultrasonoscopy indicates that diffusion range is slightly better defined than that of instant injection; 24 hours within efficacy scope, uneven sound enhancement, obvious at injecting point, followed by edge echo. Pathological findings indicate light pink staining, lack of evenness, obvious meronecrobiosis near injecting point, smooth muscle cells and cell nucleus edema and partially destroyed blood vessels visible at the edge. 2.4 Injecting 1ml of different sclerosing agents, observe diffusion ranges at different periods:Instant diffusion ranges, absolute ethyl alcohol groups 0.77±0.10cm、high-temperature normal saline groups 0.60±0.07 cm 、 high-temperature hypertonic saline groups 0.77±0.08 cm, compare the three groups, with statistical difference, P<0.05; compare absolute ethyl alcohol, high- temperature hypertonic saline and high-temperature normal saline groups, with statistical differences; for the rest, no statistical difference.0.5 hour compare the diffusion ranges of the three groups, 0.75±0.12cm、0.60±0.08cm、0.74±0.08 cm, with statistical difference, P<0.05; compare absolute ethyl alcohol, high-temperature hypertonic saline and high- temperature normal saline groups, with statistical differences; for the rest, no statistical difference.1 hour diffusion ranges comparison of the three groups, 0.71±0.12cm、0.55±0.08cm、0.68±0.11 cm, with statistical difference, P<0.05; compare absolute ethyl alcohol, high-temperature hypertonic saline and high- temperature normal saline groups, with statistical differences; for the rest, no statistical difference.Compare diffusion ranges of the three groups on 24 hours, 0.65±0.12cm、0.51±0.09cm、0.66±0.12 cm,with statistical differences, P<0.05; compare, it indicates that absolute ethyl alcohol, high- temperature hypertonic saline and high-temperature normal saline groups, with statistical difference; for the rest, no statistical difference. 2.5 Injecting 2ml of different sclerosing agents, observe diffusion ranges at different periods:Compare the three groups at instant, 0.5 hour, 1 hour and 24 hours, all with statistical significance.Conclusion:Excised human fibroid injected with different drugs under ultrasonic guidance, compares their treatment effect and finds, the medication injection into fibroid under the ultrasonic guidance The treatment effect of absolute ethyl alcohol group is better than that of high-temperature hypertonic saline group, and the treatment effect of high-temperature hypertonic saline group is better than that of high- temperature normal saline group. |
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