探讨超声引导下经皮微波消融治疗症状性子宫腺肌病的疗效及并发症处理  

Discuss the Curative Effect and Complication Management of Symptomatic Uterine Adenomyosis with Ultrasound-guided Percutaneous Microwave Ablation Treatment

作　　者：彭红艳[1] 余松远[1] 贺飞[1] 金婷 李蕾[1] 张玲[1] 吴华丽[1] 

机构地区：[1]武汉科技大学附属天佑医院超声医学科,武汉市430064

出　　处：《中国超声医学杂志》2018年第1期59-61,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨超声引导下经皮微波消融治疗症状性子宫腺肌病的疗效及并发症处理对策。方法对54例子宫腺肌病患者行超声引导下经皮微波消融治疗,超声造影观察病灶消融范围,并随访疗效,术中及术后监测并记录患者并发症发生情况及应对措施。结果微波消融治疗后,超声造影观察病灶平均消融率达81.8%,所有患者临床症状明显改善,治疗有效率达100%;术中有6例患者在局麻下出现心动过缓;术后有1例出现肠道粘连,1例出现急性肾功能衰竭,1例出现血小板急骤增多,1例出现血小板急骤减少。全部患者治疗后随访期内未发现穿刺针道子宫内膜异位种植现象。结论超声引导经皮微波消融治疗症状性子宫腺肌病疗效确切,并发症少;术中把握好病灶厚度和范围、穿刺路径等是防止并发症发生的有效措施,全身支持、对症等治疗可以有效地应对术中和术后并发症。Abstract：Objective To discuss the curative effect and complications managements with ultrasound-guided per- cutaneous microwave ablation for the treatment of symptomatic uterine adenomyosis. Methods 54 patients of uterine adenomyosis with ultrasound-guided percutaneous microwave ablation, the scope of focal ablation was observed by ul- trasound contrast,and recorded the curative effect follow-up, the intraoperative and postoperative complications and countermeasures. Results After the treatment of microwave ablation, the average ablation rate of the lesions was 81.8~, and the clinical symptoms of all patients were improved significantly, and the effective rate was 100~. 6 ca- ses appeared bradycardia intraoperative under local anesthesia; 1 case intestinal adhesion, 1 case developed acute renal failure, 1 case increased and 1 case decreased rapidly in platelet counts. All patients had no needle tract implantation metastases after treatment. Conclusions Ultrasound-guided percutaneous microwave ablation for the treatment symp- tomatic uterine adenomyosis is effective and safe;In the process of treatment holding thickness and area of lesions,the puncture path and so on will be a effective measure which can prevent complications, systemic support and symptomat- ic treatment can effectively cope with intraoperative and postoperative complications.

关 键 词：微波消融 子宫腺肌病 疗效 并发症处理 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711.71[医药卫生—诊断学]