不孕症患者子宫肌瘤HIFU消融术后妊娠相关影响因素分析  

Analyze Relevant Influence Factors on Reproductive Outcomes after HIFU Ablation Treatment for Infertile Women with Uterine Fibroids

作　　者：李俊书[1] 陈文直[1] 胡亮[1] 李丹[1] 王勇[1] 王熙[2] 陈锦云[2] 

机构地区：[1]重庆医科大学生物医学工程学院,省部共建国家重点实验室培育基地--重庆市超声医学工程重点实验室,重庆市生物医学工程学重点实验室,重庆市微无创医学协同创新中心,重庆市400016 [2]重庆医科大学附属第一医院超声消融治疗中心

出　　处：《中国超声医学杂志》2016年第11期1018-1022,共5页Chinese Journal of Ultrasound in Medicine

基　　金：十二五科技支撑项目(No.2011BAI14B01)

摘　　要：目的探讨合并不孕症的子宫肌瘤患者行高强度聚焦超声(HIFU)治疗后妊娠和妊娠结局及其影响因素。方法选择在我院行HIFU消融术的不孕症的子宫肌瘤患者46例,收集临床资料、肌瘤的MRI特征信息,进行术后妊娠相关情况随访。结果术后中位随访时间为3年,46例患者中HIFU术后9例妊娠,妊娠率19.6%。成功分娩5例,剖宫产3例,正常分娩2例。将所有研究对象根据妊娠结局的不同,分为妊娠组和未妊娠组,两组在术前妊娠丢失次数、术前不孕史类型、肌瘤类型、子宫内膜线是否受压、子宫肌瘤个数等进行单因素回归分析比较,差异均有统计学意义(P<0.05)。多因素分析结果仅术前不孕类型对术后妊娠的影响,差异有统计学意义(B=-4.809,P<0.05)。结论对于不孕症的子宫肌瘤患者行HIFU消融治疗能有效改善子宫环境,提高术后妊娠率及继续妊娠率。Objective To study the pregnancy, reproductive outcome and relevant influence factors of infertile women with uterine fibroids after high intensity focused ultrasound （HIFU）treatment. Methods 46 infertile women with uterine fibroids after HIFU treatment in our hospital were selected. The basic clinical information, fibroids＇ MRI feature were collected, and pregnancy information after treatment were folloued-up. Results After the treatment, there were 9 pregnancy cases in the total infertile women,pregnancy rate was 19.6% during the median follow up time three years. The number of live births was 5. Among them,3 were cesarean delivery,2 were delivery by vagina. All subjects, according to the outcome of pregnancy, were divided into pregnancy group and non-pregnancy group. Through single factor analysis, the differences in number of abortion history, infertility type, fibroid type,number of fihroids, wether pressure on uterine cavity and other factors in the two group were all statistically signifieant（P〈0.05）. There was only a statistically significant difference about utility type before HIFU treatment after multiple-factor analysis （B =-4. 809,P%0.05）. Conclusions HIFU treatment for infertile women with uterine fibroids can improve the pregnancy rate and ongoing pregnancy rate.

关 键 词：不孕 子宫肌瘤 妊娠结局 高强度聚焦超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711.6[医药卫生—诊断学] R737.33[医药卫生—临床医学]