高强度聚焦超声治疗≥3cm Ⅰ~Ⅱ型子宫黏膜下肌瘤的疗效观察  

作　　者：王巧巧 陈萍[1] 邵建苗 屠丹丹[1] 

机构地区：[1]浙江绍兴绍兴第二医院医共体总院,312000

出　　处：《浙江临床医学》2023年第5期723-725,共3页Zhejiang Clinical Medical Journal

基　　金：绍兴市科技计划项目(2020A13067)。

摘　　要：目的探讨高强度聚焦超声(HIFU)消融治疗直径≥3 cm Ⅰ~Ⅱ型子宫黏膜下肌瘤的疗效及其安全性。方法选取2019年6月至2020年6月瘤体直径≥3 cm的Ⅰ~Ⅱ型子宫黏膜下肌瘤患者36例,在镇静、镇痛下行HIFU消融治疗。治疗后随访12个月,分别在治疗后第3、6、12个月对月经经期及经量进行记录,并检测其血红蛋白水平及靶肌瘤体积。同时依照HIFU并发症(肠穿孔、腰骶神经损伤、皮肤损伤、下腹痛等)及患者远期归转情况评价HIFU治疗后相关的不良反应。结果在HIFU治疗后3、6、12个月,靶肌瘤平均体积分别缩小59.5%,79.3%和86.9%,差异均有统计学意义(P<0.01);在接受HIFU治疗3、6、12个月后,患者经量增多及经期延长均较术前好转(P<0.01),血红蛋白比治疗前升高(P<0.01),临床症状逐渐改善;36例患者均未出现肠穿孔,皮肤损伤,神经损伤等严重不良反应,无患者行再次HIFU干预或其他手术治疗。结论应用HIFU治疗≥3 cm Ⅰ~Ⅱ型子宫黏膜下肌瘤能有效缩小靶肌瘤体积,改善患者月经量增多及经期延长症状,改善贫血指标,提高患者生活质量,是有效且安全的,值得临床推广应用。Objective To explore the efficacy and safety of high intensity focused ultrasound(HIFU)ablation in the treatment of Type Ⅰ/Ⅱ submucosal uterine myoma with a diameter≥3 cm.Methods From June 2019 to June 2020,a total of 36 women of Type Ⅰ/Ⅱ submucous myomas with lesion diameter larger than 3 cm which treated with HIFU ablation in our hospital were included in this study.All patients were followed up for 12 months,and the menstrual period,menstrual volume,the hemoglobin level and target myoma volume were recorded at 3,6 and 12 months after the treatment.At the same time,the related complications,as well as the long-term prognosis,were evaluated including intestinal perforation,lumbosacral nerve injury,skin injury and lower abdominal pain.Results The average volume of target myoma significantly decreased by 59.5%,79.3%and 86.9%respectively in 3,6 and 12 months after HIFU treatment,with statistical significance(P<0.01).The menorrhagia and anemia of the patients were significantly improved compared with those before HIFU intervention(P<0.01).In addition,no complications such as intestinal perforation,skin injury or nerve injury occurred in participated women,and no patients underwent second HIFU intervention or other surgical treatment.Conclusion HIFU ablation has a definite effect on the treatment of Type Ⅰ/Ⅱ submucosal uterine myoma with a diameter≥3 cm by reducing the volume of myoma to improve menorrhagia and anemia.Therefore,HIFU ablation is worthy of being popularized and applied in clinics according to its efficacy and safety.

关 键 词：高强度聚焦超声 子宫黏膜下肌瘤 有效性 安全性 不良反应 

分 类 号：R737.33[医药卫生—肿瘤]