超声引导在宫颈癌近距离放射治疗中预防子宫再穿孔的应用价值  

The Value of Ultrasound Guidance for Prevention of Uterine Reperforation in Brachytherapy of Cervical Cancer

作　　者：李佳密 卢漫[2] 李婷婷 王先良[3] 王诗诗 庄敏 梁莹 Li Jiami;Lu Man;Li Tingting;Wang Xianliang;Wang Shishi;Zhuang Min;Liang Ying(School of Medical Imaging,North Sichuan Medical College,Nanchong,Sichuan 637000,China;Department of Ultrasound,Sichuan Cancer Hospital,Chengdu 610041,China;Radiotherapy Center,Sichuan Cancer Hospital,Chengdu 610041,China)

机构地区：[1]川北医学院医学影像学院,四川省南充市637000 [2]四川省肿瘤医院超声医学中心,成都市610041 [3]四川省肿瘤医院放疗中心,成都市610041

出　　处：《中国超声医学杂志》2023年第9期1034-1037,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨超声引导在预防已发生子宫穿孔的宫颈癌患者近距离放射治疗中再次发生穿孔的临床应用价值。方法回顾性分析了31例宫颈癌患者的155次近距离放射治疗,根据术后CT图像评估子宫是否穿孔、穿孔位置及深度,比较超声引导前后的子宫穿孔率。结果术后经CT诊断子宫穿孔共计44次,超声引导后子宫穿孔率显著低于超声引导前的子宫穿孔率(8.08%vs.64.28%,P<0.001);超声引导前的穿孔位置位于子宫下段、子宫中上段及宫底,穿出的平均深度为2.35 cm;超声引导后的穿孔位置位于子宫上段及宫底,穿出的平均深度为1.56 cm。结论超声引导在已发生子宫穿孔的宫颈癌后续近距离放射治疗中有重要的临床应用价值,能明显降低子宫再穿孔率,改善宫腔管的位置及穿孔深度。Objective To investigate the clinical value of ultrasound guidance for prevention of uterine reperforation after uterine perforation occuring during brachytherapy for cervical cancer.Methods A total of 155 brachytherapy in 31 patients with cervical cancer were retrospectively analyzed.The perforation rate,location,and depth of perforation were evaluated according to postoperative CT images,and the uterine perforation rate before and after ultrasound guidance was compared.Results Postoperative CT showed 44 cases of uterine perforation.The rate of uterine perforation after ultrasound guidance was significantly lower than that before ultrasound guidance(8.08%vs.64.28%,P0.001).Before ultrasonic guidance,the perforations were located in the lower segment of the uterus,the middle upper uterine segment,and the fundus of the uterus,and the average penetration depth was 2.35 cm.Ultrasound-guided perforations were located in the upper uterine segment and the fundus of the uterus,and the average penetration depth was 1.56 cm.Conclusions Ultrasound guidance has substantial therapeutic application value in subsequent brachytherapy for cervical cancer with uterine perforation,which can significantly reduce the rate of uterine reperforation and improve the position of tandem and depth of perforation.

关 键 词：宫颈癌 近距离放射治疗 超声引导 

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