微波消融治疗子宫肌瘤的实验研究及临床应用  

Experimental study and clinical application of microwave ablation in treatment of uterine fibroids

作　　者：段小民[1] 郭利军[1] 张续明[2] 刘晓明[2] 蒋学琴[1] 

机构地区：[1]汉中市人民医院超声诊疗科,陕西汉中723000 [2]汉中市人民医院肿瘤科,陕西汉中723000

出　　处：《临床和实验医学杂志》2014年第4期303-306,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的评价超声引导下微波消融治疗(PMAT)子宫肌瘤的疗效。方法在体子宫肌瘤10例患者,开腹子宫切除术中,切开腹壁暴露子宫,超声引导下将微波针穿刺入肌瘤部位,启动微波消融,切除子宫后切开肌瘤标本,测量消融灶的长、宽、厚。离体子宫标本18个,穿刺肌瘤部位,启动微波消融,切开标本,测量消融灶的长、宽、厚。结果①在体子宫消融范围:功率60 W,时间180 s及300 s,形成消融灶平均长、宽、厚分别为3.25 cm×2.62 cm×2.45 cm,4.71cm×3.49 cm×3.24 cm。②离体子宫消融范围:功率60 W,时间180 s及300 s,形成消融灶平均长、宽、厚分别为3.20cm×2.27 cm×1.79 cm,3.83 cm×2.94 cm×2.65 cm。③25例子宫肌瘤患者:32个结节中,28个肌瘤结节完全坏死,4个肌瘤结节边缘部分增强,1结节周边增厚,血流增多;全部患者术后无严重并发症发生。结论子宫肌瘤微波消融较为完全,消融效率高,治疗时间短,并发症少,安全可靠。Objective To evaluate the effect of ultrasound - guided percntaneous microwave ablation in treatment of uterine fibroids. Methods The uteri of 10 patients had been dissected during laparohysterectomy through abdominal incision, ultrasound - guided microwave nee- dle had been pierced into different parts of fibroids, then the microwave irradiated from therapeutic apparatus with 60 W forlS0 s to 300 s, after re- moval of the uterus, specimens of myoma were e×amined for length, width and thickness of lesions for ablation. The specimens of uterus in 18 pa- tients with myoma were punctured under the guidance of ultrasound, then the microwave ablation was started with 60 w, for 180 s and 300 s, the foci for ablation were measured for their length, width and thickness. Results （ 1 ） The range of ablation on uterine in vivo was 60 W, for 180 s and 300 s, the average length, width and thickness of foci for ablation were 3.25 cm × 2.62 cm × 2.45 cm and 4.71 cm × 3.49 cm × 3.24 cm. （2） The scope of ablation for isolated uteri was 60 W for 180 s and 300 s, the average length, width and thickness of ablation foci were 3.20 cm × 2.27 × 1.79 cm and 3.83 cm × 2.94 cm × 2.65 cm respectively. （3） In 25 patients with uterine fibroids, 28 of 32 nodules of tubercles of myo- ma had completely been necrosed. The angiography taken 1 month after the ablation demonstrated that the edges of four tubercles of myoma were enhanced, and a half annual ree×amination showed that the blood flow in surrounding nodular thickening had been increased. All these patients had no serious postoperative complications. Conclusion Microwave ablation for treatment of uterine fibroids is relatively complete with high effi- ciency, short therapeutic time and fewer complications, hence it is safe and reliable.

关 键 词：子宫肌瘤 超声引导 微波消融技术 

分 类 号：R737.33[医药卫生—肿瘤]