高强度聚焦超声治疗子宫肌瘤  

Applying high intensity focused ultrasound in treating hysteromyoma

作　　者：董英辉[1] 段亚男[1] 白文彩 张献波[1] 

机构地区：[1]石家庄市第一医院肿瘤一科,河北石家庄050011 [2]邢台宁晋县医院妇产科,河北邢台055550

出　　处：《中国计划生育和妇产科》2012年第5期54-56,共3页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的评价高强度聚焦超声(High-intensity focused ultrasound,HIFU)治疗子宫肌瘤的疗效及安全性。方法对拒绝手术要求保留子宫的单发或多发性子宫肌瘤患者58例,采用JC200型高强度聚焦超声治疗系统,在B超定位并监视下,从体外对肌瘤进行HIFU治疗。治疗后1d、3～6个月随访观察患者临床症状、体征及瘤体影像学变化,对疗效作出评估。结果 16例患者术后1d行盆腔MRI显示子宫肌瘤组织表现为凝固性坏死,51例患者3～6个月后经量增多、经期延长症状改善,B超检查肌瘤回声增强,肌瘤血流明显减少,肌瘤体积较前缩小。58例患者HIFU治疗后近期总有效率为87.93%(疗效显著18例、有效33例),无效7例(12.07%)。依据治疗功率进行分层分析,低功率组(<300w)的平均治疗时间5.04h,明显多于高功率组(>300 w)3.10h(P<0.05),两组的有效率分别为88.6%和86.9%,差异无统计学意义(P>0.05)。结论 HIFU治疗子宫肌瘤是一种安全有效的非手术治疗方法,对于耐受性差的患者,采用低功率仍可取得一定的效果。Objective To evaluate the curative effect and safety of high intensity focused ultrasound （HIFU） in the treatment of hysteromyoma. Methods 58 patients with single or multiple hysteromyoma were treated with HIFU,who rejected operations and had strong wills to reserve uterus. In the process of treatment, real time two - dimensional uhrasonography was used to guide the location of the focal field and monitor the ablation procedure. Clinical symptoms and imaging changes were observed 1 day, and in 3 - 6 month after treatment, and the efficacy of HIFU was evaluated. Results Pelvic cavity MRI showed hysteromyoma tissues of 16 patients had coagulation necrosis one day after treatment. 3 - 6 months later, symptoms in 51 patients like menometrorrhagia and bradymenorrhea were obviously relieved. B ultrasound showed an enhanced echo with obviously reduced blood flow and volume. Among 58 cases, the total effective rate was 87.93% （18 cases achieved significant curative effect, 33 cases moderate curative effect） and 7 cases failed to respond to the treatment. When stratified for the power status, the treatment time of the low power （〈300W） was significantly longer than the high power （〉300W） （P 〈0. 05）. No significant difference in the effective power was shown （P 〉 0. 05 ）. Conclusion As a non - invasive method, HIFU can treat hysteromyoma safely and effectively. For patients with poor tolerance, low power can still achieve a certain effect.

关 键 词：高强度聚焦超声 子宫肌瘤 治疗功率 疗效 

分 类 号：R737.33[医药卫生—肿瘤]