超声引导下高强度聚焦超声消融治疗有症状子宫肌瘤的疗效观察  

Effect of ultrasound guided high intensity focused ultrasound ablation on symptomatic uterine leiomyoma

作　　者：王建凤[1] 袁莉敏[1] 安旭菁[1] 孙群[1] WANG Jianfeng;YUAN Limin;AN Xujing;SUN Qun(Department of Obstetrics and Gynecology,The second Division of Xinjiang production and Construction Corps,Korla Hospital,Xinjiang,Korla,841000,China)

机构地区：[1]新疆生产建设兵团第二师库尔勒医院妇产科

出　　处：《新疆医学》2019年第4期358-360,共3页Xinjiang Medical Journal

基　　金：新疆生产建设兵团第二师铁门关市社会发展科技攻关项目(项目编号:2016SFG03)

摘　　要：目的 探讨超声引导下高强度聚焦超声消融(HIFU)治疗有症状子宫肌瘤的疗效.方法 选取2016年2月-2017年12月本院接诊的有症状70例子宫肌瘤,总计治疗使用HIFU治疗系统一次性消融子宫肌瘤共计110个肌瘤(肌瘤个数110个),其中肌瘤最大直径50 mm.HIFU治疗术后及术后6个月观察不良反应并定期随访,随访期间应用增强磁共振(MRI)评价治疗后子宫肌瘤的消融坏死体积,以判定临床转归结果.结果 27例经量增多患者中有22例(81.48%)经量明显减少;12例经期延长患者中有8例(66.67)经量恢复正常;31例痛经患者中有22例(78.97%)痛经减轻或消失;术前肌瘤平均体积为(130.89±18.65)cm3,术后6个月平均体积缩小为(44.50±12.51)cm3,治疗后体积平均缩小率为(66.00±16.98)%,差异有统计学意义(P<0.05);术后主要并发症为局部疼痛、发热等,无严重并发症发生.结论 超声引导下HIFU可有效缩小有症状子宫肌瘤体积,改善临床症状,安全性较高,值得临床推广.Objective To investigate the effect of ultrasound-guided high-intensity focused ultrasound ablation(HIFU)on symptomatic uterine leiomyoma.Methods From February 2016 to December 2017,70 patients with symptomatic uterine leiomyoma were treated with HIFU.110 uterine leiomyomas(110 leiomyomas)were treated with HIFU.The maximum diameter of myoma was 50 mm,The adverse reactions were observed and followed up regularly for six months after operation.The ablation necrosis volume of uterine leiomyoma was evaluated with enhanced magnetic resonance(MRI)during the follow-up period to judge the clinical change.Results In 22(81.48%)of 27 patients with increased menstrual volume,there was a significant decrease in menstrual volume..In 12 patients with prolonged menstrual period,there were 8 cases(66.67%)whose menstrual period returned to normal.In 31 patients with dysmenorrhea,there were 22 cases(78.97%)whose dysmenorrhea relieved or disappeared.The mean volume of leiomyoma was(130.89±18.65)cm3 before operation.6 months after treatment,the mean volume decreased to(44.50±12.51)cm3,reduction rate was(66.00±16.98)%.The difference was statistically significant(P<0.05).The main postoperative complication is local pain,fever,etc,no serious complications.Conclusions Ultrasound guided HIFU can effectively reduce the volume of symptomatic uterine leiomyoma and improve clinical symptoms.

关 键 词：有症状子宫肌瘤 高强度聚焦超声消融 超声 安全性 

分 类 号：R730.41[医药卫生—肿瘤]