高强度聚焦超声治疗子宫肌瘤的疗效分析  

Therapeutic effect of high intensity focused ultrasound in treatment of uterine fibroid

作　　者：张卫兵[1] 颜朝晖[1] 陈建[1] 何芸[1] 刘华[1] 

机构地区：[1]武警江苏总队医院超声科,扬州225003

出　　处：《武警医学》2017年第6期621-624,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨高强度聚焦超声(high intensity focused ultrasound,HIFU)治疗子宫肌瘤的临床疗效及安全性。方法 2014-03至2015-06采用HIFU治疗子宫肌瘤患者88例,观察并分析患者术中术后反应、临床症状缓解情况及影像学改变情况。结果治疗中无神经损伤、膀胱损伤、肠穿孔、皮肤烧伤等严重并发症发生;35例月经量增多患者治疗后1、3、6个月后月经量减少至原月经量的百分数分别为(71±11)%、(55±10)%、(49±11)%;21例继发性贫血患者治疗前Hb水平为(92±8)g/L、治疗后6个月血红蛋白水平为(121±13)g/L,差异有统计学意义(t=8.71,P<0.05)。24例痛经患者治疗前痛经NPIS评分为(7.8±1.1),治疗后6个月痛经NPIS评分为(2.3±0.8),差异有统计学意义(t=19.81,P<0.05)。治疗后1、3、6个月超声检查显示子宫肌瘤体积缩小率为(33.23±14.03)%、(48.42±14.56)%、(63.76±18.05)%。6个月后超声检查CDFI显示所有患者肌瘤内血流信号明显减少或消失,与治疗前比较,差异有统计学意义(Zc=9.63,P<0.05)。结论 HIFU治疗子宫肌瘤近期疗效显著,能有效减轻临床症状,是治疗子宫肌瘤的安全、有效、无创的新方法。Objective To evaluate the clinical efficacy and safety of high intensity focused ultrasound （HIFU） in the treatment of uterine fibroids.Methods Eighty-eight patients with uterine fibroids were treated with HIFU between March 2014 and June 2015. The intraoperative and postoperative reactions, clinical symptoms and imaging changes were observed and analyzed.Results There was no nerve damage, bladder injury, bowel perforation, skin burns or any other serious complications intraoperatively. The menstrual volume of 35 cases of menorrhagia patients was reduced to （71±11）%、（55±10）% and（49±11）% of the original menstrual volume after 1,3,6 months respectively. The hemoglobin level of 21 cases of secondary anemia patients was （92±8）g/L before treatment, but was （121±13） g/L 6 months after treatment. The difference was statistically significant （t=8.71,P〈0.05）. The NPIS score of dysmenorrhea of 24 cases of dysmenorrhea patients was reduced from （7.8±1.1） to （2.3±0.8） 6 months after treatment. The difference was of statistical significance （t=19.81,P〈0.05）. The volume shrinkage rate of uterine fibroids by ultrasound examination after 1 month, 3 months, and 6 months was （33.23±14.03）%, （48.42±14.56）%,and （63.76±18.05）% respectively. CDFI showed that the blood flow signals in all the patients were significantly reduced or even disappeared 6 months later. The difference was statistically significant after treatment（Zc=9.63,P〈0.05）.Conclusions The short-term curative effect of HIFU is distinct for uterine fibroids. HIFU treatment can not only relieve clinical symptoms effectively, but is a safe and noninvasive method for treating uterine fibroids.

关 键 词：高强度聚焦超声 子宫肌瘤 疗效分析 

分 类 号：R454.3[医药卫生—治疗学] R737.33[医药卫生—临床医学]