磁共振引导聚焦超声术消融症状性子宫肌瘤的效果  

Magnetic resonance-guided focused ultrasound ablation for symptomatic uterine fibroids: a preliminary study

作　　者：黄耀渠[1] 周守国[1] 王娟[1] 邓烈夏[1] 谭彩霞 李振威[2] 庞卓超[3] 衣利磊[1] HUANG Yao - qu;ZHOU Shou - guo;WANG Juan;DENG Lie - xia;TAN Cai - xia;LI Zhen - wei;PANG Zhuo - chao;YI Li - lei(Department of MRI,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,Guangdong, China)

机构地区：[1]佛山市中医院MRI室,广东佛山528000 [2]佛山市中医院麻醉科,广东佛山528000 [3]佛山市中医院妇科,广东佛山528000

出　　处：《广东医学》2019年第10期1409-1413,共5页Guangdong Medical Journal

基　　金：广东省医学科研基金立项项目(编号:B2018193);佛山市医学类科技攻关项目(编号:2017AB002661)

摘　　要：目的探讨磁共振引导聚焦超声术(MRgFUS)消融症状性子宫肌瘤的疗效。方法选择行MRgFUS治疗的症状性子宫肌瘤患者22例,记录治疗情况、不良反应。治疗后3个月复查盆腔MRI及血红蛋白浓度,治疗后3、6、12个月复查症状严重程度评分(SSS)和健康相关生命质量(HRQL)评分。结果 22例患者均完成MRgFUS治疗,共消融41个肌瘤,完成率95.3%(41/43)。非灌注体积比率57.9%~99.2%,平均(84.2±13.8)%。治疗后轻度不良反应发生率为18.2%(4/22),无严重不良反应。治疗后3个月肌瘤体积平均缩小(49.1±9.0)%,贫血者血红蛋白较治疗前升高(P<0.05)。MRgFUS治疗后3、6、12个月SSS评分均较治疗前降低,HRQL评分则较治疗前升高(P<0.05)。除治疗后6个月HRQL评分较治疗后3个月升高(P<0.05)外,其余不同随访时间的SSS和HRQL评分差异无统计学意义(P>0.05)。结论 MRgFUS是治疗症状性子宫肌瘤安全、非侵入性的方法,短期疗效较显著。但长期疗效还需要进一步观察。Objective To evaluate the application of magnetic resonance guided focused ultrasound surgery ( MRgFUS) ablation for the treatment of symptomatic uterine fibroids in terms of short - term efficacy. Methods Twenty - two patients with symptomatic uterine fibroids were enrolled for MRgFUS treatment. The treatment parameters and adverse reactions were registered. Pelvic MRI and hemoglobin concentrations were reviewed 3 - month after treatment,and symp- tom severity score ( SSS) and health - related quality of life ( HRQL) of UFS - QOL questionnaire were reviewed at 3 -, 6 - and 12 - month after treatment. Results All the 22 patients were successfully ablated by MRgFUS,including 41 ( 95. 3%) of the 43 myomas. The average non - perfusion volume ratio was ( 84. 2 ± 13. 8)%( 57. 9%- 99. 2%). The incidence of mild adverse reaction after treatment was 18. 2%( 4 /22),no patient serious adverse reaction was reported. After 3 month of treatment,myoma volume was shrinked by ( 49. 1 ± 9. 0)%,and hemoglobin in anemia patients was sig- nificantly higher than that before treatment ( P < 0. 05). SSS score at 3 -,6 - and 12 - month after MRgFUS treatment was significantly reduced and HRQL was increased compared with baseline before treatment ( P < 0. 05 for all). HRQL score at 6 - month was higher than 3 - month after treatment ( P < 0. 05). Conclusion MRgFUS is a safe and non - in- vasive method for the treatment of symptomatic uterine fibroids with significant short - term efficacy. However,long - term efficacy needs to be further studied.

关 键 词：磁共振引导聚焦超声术 子宫 平滑肌瘤 疗效 

分 类 号：R737.33[医药卫生—肿瘤] R445.2[医药卫生—临床医学]