高强度聚焦超声消融与子宫动脉栓塞术治疗子宫肌瘤的临床效果比较  

Comparison of the clinical effects of the high-intensity focused ultrasound ablation and uterine artery embolization in the treatment of uterine fibroid

作　　者：冯江[1] 刘文英[1] 夏欢 曾有挺 苏翠滢 FENG Jiang;LIU Wen-ying;XIA Huan;ZENG You-ting;SU Cui-ying(Department of Obstetrics and Gynecology,Zigong Fourth People′s Hospital,Zigong 643000,China)

机构地区：[1]四川省自贡市第四人民医院妇产科,四川自贡643000

出　　处：《实用医院临床杂志》2024年第4期98-102,共5页Practical Journal of Clinical Medicine

基　　金：超声医学工程国家重点实验室开放课题(编号:2022KFK7020)。

摘　　要：目的 比较高强度聚焦超声(HIFU)与子宫动脉栓塞术(UAE)在治疗子宫肌瘤(UF)患者中的应用效果。方法 收集2020年1月至2022年6月在我院接受介入治疗的UF患者86例,根据治疗方法分为HIFU组(n=44例)与UAE组(n=42例)。比较两组应激反应、子宫内膜容受性、性激素水平、并发症及复发率。结果 术后3 d, HIFU组血清去甲肾上腺素(NE)、丙二醛(MDA)低于UAE组,超氧化物歧化酶(SOD)高于UAE组(P<0.05);术后1个月,HIFU组子宫内膜厚度高于UAE组,子宫内膜动脉血流搏动指数、子宫内膜动脉血流阻力指数低于UAE组(P<0.05);术后3个月,HIFU组血清雌二醇(E2)低于UAE组,促卵泡生长素(FSH)、促黄体生长素(LH)高于UAE组(P<0.05);随访12个月,HIFU组并发症34.09%低于UAE组57.14%,复发率22.73%高于UAE组7.14%(χ^(2)=4.607, 4.067,P<0.05)。结论 HIFU治疗能够缓解UA患者应激反应程度,改善子宫内膜容受性及性激素水平,减少并发症的发生,但有诱发术后复发的风险。Objective To compare the efficacy of high-intensity focused ultrasound(HIFU)and uterine artery embolization(UAE)in the treatment of uterine fibroid(UF).Methods Eighty-six patients with UF undergoing interventional therapy from January 2020 to June 2022 were collected.The patients were divided into a HIFU group(n=44)and an UAE group(n=42)according to treatment methods.Stress response,endometrial receptivity,sex hormone level,complication and recurrence rate were compared between the two groups.Results After 3 days of operation,serum norepinephrine(NE)and malondialdehyde(MDA)were lower and superoxide dismutase(SOD)was higher in the HIFU group than those in the UAE group(P<0.05).After one month of operation,endometrial thickness was higher and endometrial artery blood flow pulsatility index and endometrial artery blood flow resistance index were lower in the HIFU group than those in the UAE group(P<0.05).After 3 months of operation,serum E2 was lower and FSH and LH in the HIFU group were higher than those in the UAE group(P<0.05).Follow-up 12 months,complication in the HIFU group was 4.09%that was lower than 57.14%in the UAE group(χ^(2)=4.607,P<0.05).Recurrence rate in the HIFU group was 22.73%that was higher than 7.14%in the UAE group(χ^(2)=4.067,P<0.05).Conclusions HIFU therapy can alleviate the stress response of UF patients,improve the endometrial receptivity and sex hormone level,and reduce the postoperative complications.However,it has a risk of inducing postoperative recurrence.

关 键 词：子宫肌瘤 高强度聚焦超声 子宫动脉栓塞术 应激反应 子宫内膜容受性 性激素 

分 类 号：R737.3[医药卫生—肿瘤]