超声引导经皮微波消融治疗症状性子宫腺肌病患者的疗效和安全性  

Efficacy and safety of ultrasound-guided percutaneous microwave ablation in patients with symptomatic adenomyosis

作　　者：邓尔雅 李秋燕 朱菁莪 李嘉欣 李小龙[2,3,4] 张会丽 余松远 DENG Erya;LI Qiuyan;ZHU Jinge;LI Jiaxin;LI Xiaolong;ZHANG Huili;YU Songyuan(School of Medicine,Anhui University of Science and Technology,Huainan 232001,Anhui Province,China;Department of Ultrasound,Tenth People's Hospital,Tongji University,Shanghai 200072,China;Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment,Shanghai 200072,China;Department of Ultrasound,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]安徽理工大学医学院,安徽淮南232001 [2]同济大学附属第十人民医院医学超声科,上海200072 [3]上海超声诊疗工程技术研究中心,上海200072 [4]复旦大学附属中山医院超声科,上海200032

出　　处：《肿瘤影像学》2023年第2期182-188,共7页Oncoradiology

基　　金：上海市科技计划项目(21Y21901200)。

摘　　要：目的:探讨超声引导下经皮微波消融(microwave ablation,MWA)治疗有症状的子宫腺肌病患者的疗效和安全性。方法:纳入2020年7月—2021年6月接受超声引导下MWA的34例子宫腺肌病患者。在治疗后1、3、6和12个月的随访中对子宫体积、子宫腺肌病体积、痛经评分、月经血量、血红蛋白(hemoglobin,Hb)水平、症状严重程度评分(symptom severity score,SSS)和健康相关生活质量评分(health-related quality of life score,HRQL)量表进行评估。结果:中位随访时间为12.00(10.50,12.00)个月。在12个月的随访中,MWA治疗后中位子宫体积从148.45(92.08,215.62)mL减少到87.62(55.90,132.97)mL(P<0.001),中位腺肌症体积从61.08(31.28,93.38)mL减少到13.33(7.95,43.20)mL(P<0.001)。视觉模拟评分(visual analog scale,VAS)、Hb水平、月经失血图(pictorial blood loss assessment chart,PBAC)评分均较术前明显改善(P<0.05)。同时,术后的SSS和HRQL评分较MWA前也显示出差异有统计学意义(P<0.05)。无严重并发症发生且所有轻微并发症均为自限性。结论:MWA是治疗症状性子宫腺肌病的一种有效又安全的选择。超声引导下MWA治疗子宫腺肌病在使子宫体积和病灶体积的减少的同时,能明显有效地改善患者痛经、贫血和月经过多症状。Objective:To explore the efficacy and safety of ultrasound(US)-guided percutaneous microwave ablation(MWA)in patients with symptomatic adenomyosis.Methods:From July 2020 to June 2021,34 patients with symptomatic adenomyosis received US-guided percutaneous MWA were included in this retrospective study.Uterus volume,adenomyosis volume,dysmenorrhea,menstrual blood volume,hemoglobin(Hb)level,symptom severity score(SSS)and health-related quality of life score(HRQL)were evaluated at 1-,3-,6-and 12-month of follow-up after treatment.Results:The median follow-up time was 12.00(10.50,12.00)months.At the 12-month follow-up,median uterine volume decreased from the baseline volume of 148.45(92.08,215.62)mL to 87.62(55.90,132.97)mL(P<0.001)and median adenomyosis volume decreased from 61.08(31.28,93.38)mL to 13.33(7.95,43.20)mL(P<0.001).The visual analog scale(VAS),Hb level,and pictorial blood loss assessment chart(PBAC)were significantly improved compared to the preoperative period(P<0.05).Meanwhile,the postoperative SSS and the HRQL score also showed statistically difference from those before MWA(P<0.05).No major complications occurred and all minor complications were self-limiting.Conclusion:MWA is an effective and safe alternative for the symptomatic adenomyosis.Patients with adenomyosis treated with US-guided MWA resulted in a reduction in uterine volume and adenomyosis volume while significantly improving the symptoms of dysmenorrhea,anemia and menorrhagia.

关 键 词：子宫腺肌病 超声引导 微波消融 安全性 有效性 

分 类 号：R711.71[医药卫生—妇产科学] R445.1[医药卫生—临床医学]