微波组织凝固治疗宫颈肌瘤5年随访报告  

A 5-year follow-up study on cervical myoma treated with microwave

作　　者：戴秋玲[1] 李怀芳[1] 王建军[1] 张俊发[1] 樊伯珍[1] 

机构地区：[1]同济大学附属同济医院妇产科,上海200065

出　　处：《同济大学学报（医学版）》2007年第1期61-63,共3页Journal of Tongji University(Medical Science)

摘　　要：目的探讨微波组织凝固治疗宫颈肌瘤的中远期疗效及并发症。方法对78例不同类型的宫颈肌瘤患者用微波手术器行组织凝固治疗并随访,有完整随访5年的资料48例,观察局部愈合、临床症状改善及复发等情况。结果78例宫颈肌瘤,术后2周复查,痊愈35例,其中带蒂肌瘤28例;3周复查痊愈29例;4周后痊愈14例。有6例在术后2周有局部出血并予三氯化铁局部烧灼止血。术后6个月观察宫颈形状恢复正常,原瘤床处不留疤痕,临床症状消失。48例随访5年的患者术后2周痊愈19例;3周痊愈21例;4周后痊愈8例。短期随访全部病例均一次治疗成功,症状消失。5年时36例临床症状与体征与短期效果相当,9例宫颈有影像学肌瘤复发,但无临床症状及体征,3例体检可见宫颈肌瘤并活检证实,且伴有临床症状。结论微波组织凝固治疗宫颈肌瘤短期效果好,患者容易接受,几乎无并发症,但长期有一定复发,可能与肌瘤生长的位置、手术操作、组织凝固的范围等因素有关,也不排除新生肌瘤的可能。Objective To discuss the middle and long term effectiveness and the intercurrent diseases of microwave coagulation in cervical myoma. Methods All 78 patients with different types of cervical myomas were treated by microwave applicators, including 48 patients with a complete 5-year follow-up. The improvement of clinical symptom and recrudescence were studied. Results Of the 78 cases, 35 cases were cured after 2 weeks in which there were 28 cases of pedunculated myomas. 29 cases healed up after 3 weeks and 14 cases were cured after 4 weeks. 6 cases occurred local bleeding in 2 weeks after treatment and were treated with FeCl3 （Ferric chloride hexahydrate） for hemostasia. The shape of cervices of all cases came back without any scars and the clinical symptoms vanished. Of the 48 cases with a full 5-year follow-up, 19 cases were recovered after 2 weeks and 21 cases cured after 3 weeks. 8 cases healed up after 4 weeks. A short term follow-up study found that all the patients were cured with disappearance of symptoms. 5-year follow-up study reveal 36 cases kept the same effectiveness as that in short term. Another 9 cases showed imageological recrudescence without symptoms and signs. 3 cases were found cervical myomas with symptoms and were diagnosed by pathology. Conclusion Treatment of microwave coagulation shows a perfect short term effectiveness with few intereurrent diseases and easy to be accepted by patients. However, there is risk to recrudesce in the long term which may be related with the location of myomas, the way of operation and range of coagulation, Besides, the possibility of new myoma generation can not be eliminated.

关 键 词：微波 组织凝固 宫颈肌瘤 随访 

分 类 号：R713[医药卫生—妇产科学]