超声引导下高强度聚焦超声消融治疗子宫肌瘤疗效及术后生活质量  

Efficacy of high-intensity focused ultrasound ablation by ultrasound-guided for treating patients with uterine myomas and the postoperative quality of life of the patients

作　　者：忻超 邵碧红 施吉耀 XIN Chao;SHAO Bihong;SHI Jiyao(Ningbo Haishu People's Hospital,Ningbo,Zhejiang Province,315010)

机构地区：[1]宁波市海曙区人民医院,315010

出　　处：《中国计划生育学杂志》2024年第1期162-166,共5页Chinese Journal of Family Planning

摘　　要：目的:探究超声引导下高强度聚焦超声(HIFU)与腹腔镜子宫肌瘤剔除术(LM)治疗子宫肌瘤的临床疗效,并分析患者术后生活质量.方法:收集2021年1月-2022年1月本院收治有生育要求的子宫肌瘤患者100例,根据手术方式不同分为腹腔镜下子宫肌瘤剔除术的LM组以及使用采用超声引导下进行高强度聚焦超声消融的HIFU组,比较两组治疗疗效、围术期指标、术后不良反应、术后6个月生活质量以及肌瘤残留及复发情况.结果:HIFU组治疗总有效率(100.0%)高于LM组(92.0%),手术时间(55.8±12.8min)、住院时间(1.7±0.8d)及术后至完全恢复时间(4.9±2.2d)少于LM组(80.4±12.3min、2.8±0.9d、7.3±0.6d),术中出血量(0)低于LM组(127.6±22.2ml),下腹疼痛发生率(24.0%)低于LM组(44.0%)(均P<0.05).HIFU组与LM组术后3个月肌瘤残留率(2.0%、4.0%)和术后6个月肌瘤复发率(0、2.0%)无差异(P>0.05).术后6个月,HIFU组UFS-QOL问卷评分和SF-36量表评分均优于LM组,月经量评分(92.81±26.79分)少于LM组(114.65±28.61分),月经量过多发生率(6.0%)低于LM组(22.0%)(均P<0.05).结论:经阴道HIFU子宫肌瘤剔除术疗效和安全性更好,术后患者生活质量更高,值得推广用于有生育需求患者.Objective:To explore the elinical efficacy of high-intensity focused ultrasound(HIFU)ablation by ultrasound-guided and laparoscopic myomectomy(LM)for treating patients with uterine myomas of,and to analyze the postoperative quality of life of the patients.Methods:100 patients with uterine myoma who had fertilty needs from January 2021-January 2022 were collected.According to the different methods of surgery,the patients were given treatment of laparoscopic myomectomy in group A and the patients were given treatment of HIFU ablation by ultrasound guided in group B.The curative efect,the perioperative index,the postoperative adverse reactions,the quality of life in 6 months after surgery and the situations of fibroids residue and recurrence of the patients were compared between the two groups.Results:The total efective rate(100.0%)of the patients in group B was significantly higher than that(92.0%)of the patients in group A.The operation time(55.8±12.8min),the hospital stay(1.7±0.8d)and the time to complete recovery(4.9±2.2d)of the patients in the group B were significantly shorter than those(80.4±12.3min,2.8±0.9d and 7.3±0.6d)of the patients in group A,and the intraoperative blood loss(0)of the patients in the group B was significantly less than that(127.6±22.2ml)of the patients in group A.The incidence of lower abdominal pain(24.0%)of the patients in the group B was significantly lower than that(44.0%)of the patients in group A(all P<0.05).There were no significant differences in the residual rate of myoma in 3 months after surgery(2.0%vs.4.0%)and the recurrence rate in 6 months after surgery(0 vs.2.0%)of the patients between the two groups(P>0.05).In the 6th month after surgery,the UFS QOL score and SF 36 scale score of the patients in the group B were significantly better than those of the patients in group A.The menstrual volume score(92.81±26.79 points)and the incidence of menorrhagia(6.0%)of the patients in the group B were significantly lower than those(114.65±28.61 points.and 22.0%)of the patients

关 键 词：腹腔镜子宫肌瘤剔除术 超声引导下高强度聚焦超声 临床疗效 生活质量 术后复发 肌瘤残留 

分 类 号：R737.33[医药卫生—肿瘤]