实时超声引导微波消融术治疗子宫腺肌瘤的临床应用研究  

Clinical application of real-time ultrasound-guided microwave ablation in the treatment of adenomyoma

作　　者：朱凌源 刘蕊 李卫群[1] 朱彪[1] 刘向阳[1] 金泽宏[1] 毕方平 ZHU Lingyuan;LIU Rui;LI Weiqun;ZHU Biao;LIU Xiangyang;JIN Zehong;BI Fangping(Department of Ultrasonography,Inpatient Department,Loudi Central Hospital in Hunan Province,Loudi 417000,China)

机构地区：[1]湖南省娄底市中心医院住院部超声科,湖南娄底417000

出　　处：《中国现代医生》2020年第19期119-122,F0003,共5页China Modern Doctor

基　　金：湖南省科技厅技术创新引导计划项目(2017SK51207);湖南省卫生计生委科研计划(B20180854)。

摘　　要：目的探讨实时超声引导微波消融术治疗子宫腺肌瘤的临床应用。方法选取2015年1月~2019年1月收入我院子宫腺肌瘤患者37例为研究对象。采用超声造影评价患者的腺肌瘤消融率,常规超声评价瘤体缩小率。采用临床疗效评定标准来评价患者临床症状改善情况。结果痛经改善率为78.9%(15/19),月经失调改善率为42.9%(9/21),贫血改善率为55.6%(10/18)。超声造影显示仅3例出现消融不完全,消融有效率为91.9%,术后行补充消融治疗,37例局限性子宫腺肌瘤平均消融率均达90%以上。与治疗前比较,治疗后3、6、12个月患者瘤体缩小率分别为60.8%、78.1%、93.1%,差异有统计学意义(P<0.05)。与治疗前比较,治疗后临床症状有改善。结论实时超声引导微波消融术治疗子宫腺肌瘤患者,能够减小腺肌瘤体积,且能够明显改善患者临床症状,为子宫肌瘤患者提供新的治疗手段。Objective To explore the study of the clinical application of real-time ultrasound-guided microwave ablation against adenomyoma.Methods 37 patients with adenomyoma admitted to our hospital from January 2015 to January 2019 were selected as the subjects of research.Contrast-enhanced ultrasound was used to evaluate the ablation rate of the patients'adenomyoma and conventional ultrasound was used to evaluate the tumor reduction rate.The clinical efficacy evaluation criteria were used to evaluate the amelioration of the patients'clinical symptoms.Results The amelioration rate of dysmenorrhea was 78.9%(15/19),the amelioration rate of menstrual disorder was 42.9%(9/21),and the amelioration rate of anemia was 55.6%(10/18).Contrast-enhanced ultrasound showed that only 3 patients had incomplete ablation,and the effective rate of ablation was 91.9%.Since supplementary ablation was performed after operation,the average ablation rate of 37 cases of localized adenomyoma was above 90%.Compared with that before treatment,the tumor reduction rate of the patients at 3,6 and 12 m after treatment was 60.8%,78.1%and 93.1%respectively,with statistically significant differences(P<0.05).Compared with those before treatment,the clinical symptoms were ameliorated after treatment.Conclusion Real-time ultrasound-guided microwave ablation for the patients with adenomyoma can reduce the volume of adenomyoma and significantly ameliorate the patients’clinical symptoms.It provides a new therapy regimen for the patients with adenomyoma.

关 键 词：超声引导 微波消融 子宫腺肌瘤 超声造影 

分 类 号：R445.1[医药卫生—影像医学与核医学]