HIFU治疗子宫肌瘤对卵巢功能的影响  

Effect of HIFU on the ovarian function in the treatment of uterinefibroids

作　　者：冯敏清[1] 张汝坚[1] 陈向东[1] 郑玉华[1] 陈莉婷[1] 王浩[1] 陆红梅 徐智立[1] FENG Minqing;ZHANG Rujian;CHEN Xiangdong;ZHENG Yuhua;CHEN Liting;WANG Hao;LU Hongmei;XU Zhili(Department of Gynecology,Foshan Maternal and Child Health Care Hospital,Foshan 528000,Guangdong,China)

机构地区：[1]佛山市妇幼保健院妇科,广东佛山528000

出　　处：《中国性科学》2018年第12期88-92,共5页Chinese Journal of Human Sexuality

基　　金：广东省佛山市医学类科技攻关项目(2016AB002961)

摘　　要：目的:探讨高强度聚焦超声(HIFU)治疗子宫肌瘤对卵巢功能的影响方法:选择2015年7月至2016年7月于佛山市妇幼保健院行HIFU治疗的60例子宫肌壁间肌瘤患者进行研究,根据年龄不同分为三组,A组(20岁～30岁) 20例; B组(30岁～40岁) 20例; C组(40岁～50岁) 20例。三组均行HIFU治疗,通过1年随访,比较三组术前、术后3个月、6个月和12个月时抗苗勒管激素(AMH)、促卵泡生成数(FSH)、抑制素B(INHB)、窦状卵泡数(AFC)的变化,并比较术后不良反应发生率和受孕率。结果:三组不同时间点AMH、FHS、INHB、AFC比较差异均具有统计学意义(all P <0. 05);三组术后3个月时AMH、INHB、AFC较术前比较均显著降低,差异具有统计学意义(P <0. 05),但在术后6个月、12个月时,三组AMH、INHB、AFC和术前比较差异无统计学意义(P> 0. 05);三组术后3个月时FSH较术前比较均显著升高,差异均具有统计学意义(all P <0. 05),A组、B组在术后6个月、术后12个月时,FSH和术前比较差异无统计学意义(P> 0. 05); C组术后6个月FSH仍明显高于术前(P <0. 05),术后12个月时FSH和术前比较差异无统计学意义(P> 0. 05);三组术后均未出现神经损伤等严重不良反应,三组阴道流血、皮肤烫、下腹胀痛、腰骶部疼痛发生率分别为比较,差异无统计学意义(P> 0. 05);在随访1年内显示,A组受孕率为25. 00%(5/20)、B组为15%(3/20)、C组为5. 00%(1/20),三组比较差异无统计学意义(P> 0. 05)。结论:在不同年龄段子宫肌瘤患者中使用HIFU治疗对卵巢功能的影响均较小,且术后不良反应少,安全性高。Objective:To study the effect of HIFU on the ovarian function in the treatment of uterine fibroids.Methods:60 patients with intramural myoma of uterus in our hospital from July 2015 to July 2016 were selected as research objects.They were divided into 3 groups according to their age,20 cases in group A(20~30 years old),20 cases in group B(30~40 years old)and 20 cases in group C(40~50 years old).The three groups were treated with HIFU and followed up for a year.The changes in antiMullerian hormone(AMH),follicle stimulating hormone(FSH),inhibin B(INHB)and antral follicle number(AFC)before operation and 3,6 and 12 months after operation were compared between groups.The incidence of postoperative adverse reactions and pregnancy rate were compared.Results:There were significant differences in AMH,FSH,INHB and AFC among three groups at different time points(P<0.05).At 3 months after operation,the AMH,INHB and AFC of three groups were significantly lower than those before operation(P<0.05).But the AMH,INHB and AFC of three groups before operation and at 6 months and 12 months after operation had no significant difference(P>0.05).The FSH of group A and group B before operation and at 6 months and 12 months after operation had no significant difference(P<0.05).The FHS of group C at 6 months after operation was significantly higher than that before operation(P<0.05),but there was no significant difference in FHS between before operation and at 12 months after operation(P>0.05).There were no serious adverse reactions such as nerve injury in the three groups.There was no significant difference in the incidence of vaginal bleeding,skin perm,abdominal distention and pain,lumbosacral pain among three groups(P>0.05).Within the 1-year follow-up,the pregnancy rate of group A,B and C was 25.00%(5/20),15.00%(3/20) and 5%(1/20)respectively,without significant differences among three groups(P>0.05).Conclusions:The use of HIFU in the treatment of uterine fibroids in different age groups has little influence on ovarian function,with

关 键 词：高强度聚焦超声 不同年龄段 子宫肌瘤 卵巢功能 

分 类 号：R737.33[医药卫生—肿瘤]