虚拟现实减轻子宫内膜异位症患者经阴道超声疼痛的随机对照试验
这项开放标签随机对照试验纳入117例确诊子宫内膜异位症的绝经前女性，评估沉浸式虚拟现实眼镜在经阴道超声中减轻疼痛的效果。虽平均疼痛评分无显著差异，但VR组中重度疼痛发生率更低，且在高预期疼痛亚组中VR组实际疼痛评分显著更低。VR可能是有益的非药物辅助手段。
要点
- VR组中重度疼痛发生率33.9%，低于对照组的55.2%（p=0.027）。
- 平均疼痛评分VR组3.2±2.6 vs 对照组4.0±3.0，差异无统计学意义（p=0.08）。
- 高预期疼痛（NRS≥4）者中，VR组实际疼痛评分显著低于对照组（p=0.037）。
核心结论
- 在子宫内膜异位症女性经阴道超声时使用VR可降低中重度疼痛的发生频率，并减轻预期疼痛对疼痛感知的影响。
研究设计与样本
- 开放标签随机对照试验，在大学附属医疗中心开展，共纳入117例确诊子宫内膜异位症的绝经前女性。
主要发现
- VR组58例，对照组59例，平均疼痛评分分别为3.2±2.6和4.0±3.0，差异无统计学意义（p=0.08）。
- 中重度疼痛发生率VR组为33.9%，对照组为55.2%，差异有统计学意义（p=0.027）。
- 多因素logistic回归显示，VR使用（OR=0.26，95%CI：0.10-0.63；p=0.0027）、当前疼痛（OR=1.31，95%CI：1.02-1.69）和预期疼痛（OR=1.22，95%CI：1.00-1.49）是中重度疼痛的独立预测因素。
- 在高预期疼痛（NRS≥4）女性中，VR组实际疼痛评分显著低于对照组[3.0（1.0-5.0）vs 6.0（4.0-7.5），p=0.037]。
临床怎么用
- 可考虑在子宫内膜异位症患者的经阴道超声检查中提供VR眼镜作为非药物辅助手段，尤其对预期疼痛较高的患者。
局限性
- 开放标签设计可能引入偏倚；样本量有限；未报告盲法实施细节。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
原文
OBJECTIVE: To evaluate whether virtual reality (VR) glasses reduce pain perception during transvaginal ultrasound (TVUS) in women with endometriosis. DESIGN: Open-label randomized controlled trial. SETTING: University-affiliated medical center. PARTICIPANTS: A total of 117 premenopausal women with a confirmed diagnosis of endometriosis. INTERVENTIONS: TVUS performed with or without the use of immersive VR glasses. RESULTS: A total of 117 women were randomized to either the VR group (n = 58) or the control group (n = 59). Although mean pain scores were not significantly different (VR: 3.2 ± 2.6 vs. control: 4.0 ± 3.0; p = 0.08), moderate-to-severe pain was reported less frequently in the VR group (33.9% vs. 55.2%; p = 0.027). In a multivariate logistic regression analysis, VR use (OR = 0.26, 95% CI: 0.10-0.63; p = 0.0027), current pain [odds ratio (OR) = 1.31, 95% CI: 1.02-1.69], and anticipated pain (OR = 1.22, 95% CI: 1.00-1.49) were shown to be independent predictors of moderate-to-severe pain during TVUS. Among women with high anticipated pain [Numeric rating scale (NRS) ≥ 4], the VR group reported significantly lower actual pain scores compared to controls [3.0 (1.0-5.0) vs. 6.0 (4.0-7.5), respectively, p = 0.037]. CONCLUSION: Use of VR during TVUS in women with endometriosis reduced the frequency of moderate-to-severe pain and mitigated the impact of anticipated pain on pain perception. VR may be a beneficial non-pharmacologic adjunct in pelvic imaging for women with endometriosis. TRIAL REGISTRATION NUMBER: NCT04711408.
引用
- Cohen A, Levin I, Cohen Y, et al. Virtual Reality for Pain Reduction During Transvaginal Ultrasound in Women With Endometriosis: A Randomized Controlled Trial. J Minim Invasive Gynecol. 2026. PMID: 42013933. doi:10.1016/j.jmig.2026.04.013
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。