超声造影评估缩宫素辅助对于高强度聚焦超声消融子宫肌瘤效果的影响  

Contrast-enhanced ultrasound for evaluating impact of oxytocin on therapeutic effect of high-intensity focused ultrasound ablation of uterine fibroid

作　　者：丁桂升[1] 陈圣[1] 吴松松[1] 林宁[1] DING Guisheng;CHEN Sheng;WU Songsong;LIN Ning(Department of Ultrasound,Fujian Provincial Hospital,Shengli Clinical Medical College of Fujian Medical University,Fuzhou 350001,China)

机构地区：[1]福建医科大学省立临床学院福建省立医院超声科,福建福州350001

出　　处：《中国介入影像与治疗学》2023年第7期395-399,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的通过超声造影(CEUS)观察缩宫素对高强度聚焦超声(HIFU)消融子宫肌瘤效果的影响。方法回顾性分析48例接受缩宫素辅助HIFU治疗的子宫肌瘤患者。消融前对子宫肌瘤行首次CEUS;之后10 min以微量泵静脉泵入0.12 U/ml缩宫素20 min(1 ml/min),再次行CEUS,而后进行HIFU消融。根据泵入缩宫素后CEUS所示子宫肌瘤增强模式将患者分为无灌注组、部分灌注组及完全灌注组;对比3组消融参数、肌瘤消融率及满意消融率。结果无灌注组13例,部分灌注组27例,完全灌注组8例。3组HIFU消融参数及消融率总体差异均有统计学意义(P均<0.05)。无灌注组辐照时间、治疗时间、治疗能量及能效因子(EEF)均小于部分灌注组及完全灌注组,部分灌注组上述参数均小于完全灌注组(P均<0.05);无灌注组消融率及满意消融率大于部分灌注组及完全灌注组,部分灌注组上述参数大于完全灌注组(P均<0.05)。结论以缩宫素辅助可提高HIFU消融子宫肌瘤效果;但在部分对缩宫素不敏感患者难以实现增效作用。Objective To observe the impact of oxytocin on therapeutic effect of assisted high-intensity focused ultrasound(HIFU)ablation of uterine fibroid with contrast-enhanced ultrasound(CEUS).Methods Forty-eight patients with uterine fibroid who underwent oxytocin assisted HIFU ablation were enrolled.The first CEUS was performed before HIFU ablation.Ten min later,0.12 U/ml oxytocin was pumped into the vein with a micropump(1 ml/min)for 20 min,and then oxytocin assisted CEUS was performed,followed by HIFU ablation.According to the enhance mode of uterine fibroid displayed with oxytocin assisted CEUS,the patients were divided into no perfusion group,partial perfusion group and complete perfusion group.The ablation parameters,as well as ablation rate and satisfactory ablation rate were compared among 3 groups.Results There were 13 cases in no perfusion group,27 in partial perfusion group and 8 cases in perfusion group.Significant differences of ablation parameters,ablation rate and satisfactory ablation rate were found among 3 groups(all P<0.05).The irradiation time,treatment time,therapeutic energy and energy efficiency factor(EEF)of no perfusion group were smaller than those of partial perfusion group and complete perfusion group,while of partial perfusion group were all smaller than those of complete perfusion group(all P<0.05).Meanwhile,the ablation rate and satisfactory ablation rate of no perfusion group were all higher than those of partial perfusion group and complete perfusion group,while of partial perfusion group were higher than those of complete perfusion group(all P<0.05).Conclusion Oxytocin assistance could increase the therapeutic effect of HIFU ablation of uterine fibroid,but in subjects being not sensitive,it was difficult to achieve synergistic interaction.

关 键 词：平滑肌瘤 子宫 高强度聚焦超声消融 超声造影 缩宫素 

分 类 号：R737.33[医药卫生—肿瘤] R445.1[医药卫生—临床医学]