高强度聚焦超声单次整体治疗子宫腺肌症的临床研究  

The Clinical Study on Single Treatment of Uterine Adenomyosis by High Intensity Focused Ultrasound

作　　者：吴莺[1] 高悦[1] 王燕[1] 郎雁[1] 朱小红[1] 张水娟[1] 金志春[1] 

机构地区：[1]湖北省妇幼保健院妇科,武汉市430070

出　　处：《中国超声医学杂志》2013年第10期918-922,共5页Chinese Journal of Ultrasound in Medicine

基　　金：国家重点基础研究发展计划(973计划)项目资助(No.2011CB707905)

摘　　要：目的观察高强度聚焦超声(HIFU)单次整体治疗子宫腺肌症的临床疗效。方法采用JC200型HIFU肿瘤治疗系统治疗40例临床诊断明确的子宫腺肌症患者,治疗后1、3、6个月对患者随访,比较治疗前后患者临床症状、超声或核磁共振影像学变化。结果 HIFU治疗后1、3、6个月,治疗总有效率分别为85%(34/40)、91.4%(32/35)、88.2%(25/27),患者月经量明显减少,腹痛、贫血、痛经等临床症状明显改善。治疗后1、3、6个月超声检查或核磁共振检查显示子宫腺肌症消融灶血流减少,治疗有效率87.5%(35/40);治疗前后子宫体积分别为(232.5±10.3)cm^3和(158±11.4)cm^3,子宫明显缩小;腺肌症病灶亦较治疗前明显缩小,差异有显著性(P<0.05);而治疗后6个月临床疗效与治疗后3个月相近。治疗后超声造影显示腺肌症病灶平均灭活率为(75±5)%,其中灭活率90.0%以上的腺肌症占37.5%(15/40)。所有患者均无严重并发症发生。结论 HIFU单次治疗子宫腺肌症近期疗效好,安全,副作用小,是子宫腺肌症可供选择的一种新型无创治疗方式。Objective To evaluate the effect of high intensity focused ultrasound （HIFU） on adenomyosis. Methods 40 patients definitely diagnosed as adenomyosis were treated with HIFU and the tumor therapeutic system of the HIFU model JC200. All women were given following-up at 1, 3 and 6 months after treatment. The clinical symptoms,ultrasound images or nuclear magnetic resonance images （MRI） were compared before and after the HIFU treatment. Results The total efficiency among 40 patients is 85% （34/40） at 1 month after treatment, 91.4% （32/ 35） among 35 patients at 3 month after treatment, and 88.2%（25/27） among 27 patients at 6 months after treatment. The patients had less menstrual blood after treatment （170±25 ml before treatment; 80±15 ml after treatment）. And other clinical symptoms,such as bellyache, anemia and dysmenorrhea, all got great improvement. And the ultrasound showed that the uterine ablation lesions was significantly minished and the blood flow within the ablation lesions de- creased after treatment. The curative effect is most visible at 3 months after treatment,with a similar effect at 6 months after treatment. The average necrotic rate of adenomyosis was （75± 0.5）% after HIFU treatment with contrast en- hanced ultrasonography. The average rates of reduction in adenomyosis volume were （ 5± 0.5 ）%, （ 20±4）%, （ 40±6）%, respectively after HIFU ablation 1,3 and 6 months by evaluation of ultrasound or MRI. The clinical symptoms in the patients were improved significantly after ablation （P〈0.05）. No outstanding side effect was observed. Conclu- sions The single treatment of adenomyosis with HIFU is effective and safe without outstanding side effects. HIFU may be an option of new non-invasive treatment for symptomatic adenomyosis.

关 键 词：子宫腺肌症 平滑肌瘤 高强度聚焦超声 

分 类 号：R711.71[医药卫生—妇产科学]