267例无生育史的子宫肌瘤患者经高强度聚焦超声消融治疗术后妊娠结局分析  

Analysis of pregnancy outcomes in 267 nulliparous women after high-intensity focused ultrasound ablation of uterine fibroids

作　　者：王玲 胡亮[1] 刘畅[1] 尹娜 王智彪[1] 陈锦云[1,2] WANG Ling;HU Liang;LIU Chang;YIN Na;WANG Zhibiao;CHEN Jinyun(Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and the Ministry of Science and Technology,Chongqing Collaborative Innovation Center for Minimally-invasive and Noninvasive Medicine,College of Biomedical Engineering,Chongqing Medical University,Chongqing,400016;Uhrasound Ablation Center,the First Affiliated Hospital of Chongqing Medical University,Chongqing,400016,China)

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400016 [2]重庆医科大学附属第一医院超声消融治疗中心,重庆400016

出　　处：《第三军医大学学报》2018年第20期1865-1869,共5页Journal of Third Military Medical University

基　　金：重庆市自然科学基金(CSTC2016jcyjA0098,CSTC2016jcyjA0599)

摘　　要：目的探讨无生育史的子宫肌瘤患者经高强度聚焦超声(high-intensity focused ultrasound,HIFU)消融治疗的妊娠情况及其相关因素。方法选择2010年1月至2016年12月在重庆医科大学附属第一医院接受HIFU消融治疗子宫肌瘤的无生育史的患者423例,其中有生育计划及生育条件者267例,随访其术后妊娠情况并分析相关影响因素。结果中位随访时间为4(1~7)年,155例于HIFU术后(14. 1±12. 4)个月妊娠,共妊娠157次,术后妊娠率为58. 80%(157/267),自然受孕率93. 63%(147/157)。106次成功分娩新生儿109名,其中6名同卵双生儿;剖宫产率69. 81%(74/106)。尚有26例仍在妊娠中。多因素分析发现年龄、术前不孕史是影响术后妊娠的主要因素(P <0. 05);而肌瘤类型、肌瘤在HIFU术后的体积变化对妊娠结局无明显影响(P> 0. 05)。结论无生育史的子宫肌瘤患者经高强度聚焦超声消融治疗后有较好的妊娠率,HIFU消融治疗子宫肌瘤对无生育史有生育要求的子宫肌瘤患者有应用价值;影响术后妊娠的主要因素为年龄、术前不孕史。ObjectiveTo investigate the pregnancy outcomes in nulliparous women after high-intensity focused ultrasound （HIFU） ablation of uterine fibroids. MethodsBetween January, 2010 and December, 2016, 423 nulliparous women with uterine fibroids underwent HIFU treatment at the First Affiliated Hospital of Chongqing Medical University. A total of 267 of these women who had pregnancy intention were enrolled in this study, and their pregnancy outcomes were followed up and the factors affecting the pregnancy outcomes were explored. ResultsDuring the follow-up （median 4 years, ranging from 1 to 7 years）, a total of 157 pregnancies were recorded in 155 women. The average time to pregnancy was 14.1±12.4 months following HIFU, with a pregnancy rate of 58.80% （157/267） and a spontaneous conception rate of 93.63% （147/157）. A total of 109 live births （including 6 twins） were achieved in 106 successful deliveries, with a caesarean section rate of 69.81% （74/106）. On-going pregnancies were found in 26 women. Multivariate analysis revealed that age and a history of infertility were the primary factors affecting the postoperative pregnancy after HIFU （P〈0.05）, while the changes in myoma volume after HIFU or the type of myoma did not significantly affect the postoperative pregnancy （P〉0.05）. ConclusionNulliparous women receiving HIFU for uterine fibroids can have a favorable postoperative pregnancy outcome, suggesting the value of HIFU in treatment of uterine fibroids in nulliparous women who have pregnancy intentions. The main factors affecting postoperative pregnancy are age and a history of preoperative infertility.

关 键 词：高强度聚焦超声 消融 子宫肌瘤 妊娠 

分 类 号：R454.3[医药卫生—治疗学] R714.3[医药卫生—临床医学]