高强度聚焦超声联合宫腔镜电切术治疗子宫黏膜下大肌瘤的临床研究  

Clinical study of HIFU combined with hysteroscopic electrosurgery in treatment of submucous myoma of uterus

作　　者：冯敏清[1] 陈向东[1] 张汝坚[1] 陈莉婷[1] 郑玉华[1] 徐智立[1] FENG Min-qing;CHEN Xiang-dong;ZHANG Ru-jian;CHEN Li-ting;ZHENG Yu-hua*;XU Zhi-li(Foshan Women and Children Hospital,Foshan Guangdong 528000,P. R. China)

机构地区：[1]佛山市妇幼保健院住院部

出　　处：《中国计划生育和妇产科》2019年第10期80-83,共4页Chinese Journal of Family Planning & Gynecotokology

基　　金：佛山市科技计划项目(项目编号:2016AB002961)

摘　　要：目的探讨高强度聚焦超声(high intensity focused ultrasound, HIFU)联合宫腔镜电切术治疗子宫黏膜下大肌瘤的临床疗效与安全性。方法选取2016年6月至2017年12月佛山市妇幼保健院诊治的30例子宫黏膜下大肌瘤患者作为研究对象,按随机数字表法分为对照组和观察组,每组15例。对照组直接行宫腔镜电切术,观察组先采用HIFU治疗,1个月后再行宫腔镜电切术。比较两组宫腔镜手术时间、术中出血量、灌流量出入差及手术并发症等。结果对照组和观察组的手术时间分别为(83.93±24.65)min、(39.93±10.15) min;术中出血量分别为(140.47±109.85) mL、(60.47±37.21) mL;灌流量出入差分别为(561.33±288.94) mL、(187.53±89.24) mL,两组比较差异有统计学意义(P<0.05)。观察组宫腔镜电切术无1例发生并发症,对照组有3例发生较严重的并发症。结论 HIFU联合宫腔镜电切术治疗子宫黏膜下大肌瘤能克服单一手段的局限性,具有较好的疗效和安全性。Objective To investigate the clinical efficacy and safety of high intensity focused ultrasound(HIFU)ablation combined with hysteroscopic electroresection in the treatment of submucous myoma of uterus. Methods 30 patients with submucous myoma of the uterus treated in Foshan Women and Children Hospital from June 2016 to December 2017 were selected and then divided them into the control group and the observation group by random number table,15 cases in each group.The control group was treated with hysteroscopic electrotomy, the observation group was treated with HIFU, and then hysteroscopic electrotomy was performed one month later. The time of hysteroscopic surgery, intraoperative blood loss, discrepancy value of perfusion fluid and surgical complications were compared between the two groups. Results In the control group, the average time of the operation was(83.93±24.65) min, the average hemorrhage quantity was(140.47±109.85) mL, the average discrepancy value of perfusion fluid was(561.33±288.94) mL. In the observation group,the average time of the operation was(39.93±10.15) min, the average hemorrhage quantity was(60.47±37.21) mL, the average discrepancy value of perfusion fluid was(187.53±89.24)mL. The differences between the two groups were statistically significant(P<0.05). There were no complications in the observation group and 3 severe complications in the control group. Conclusion HIFU combined with hysteroscopic electromyomectomy for the treatment of submucous myoma of uterus can overcome the limitations of a single method, with better efficacy and safety.

关 键 词：高强度超声聚焦消融 宫腔镜电切术 子宫黏膜下大肌瘤 

分 类 号：R713.4[医药卫生—妇产科学]