比较高强度聚焦超声消融治疗弥漫性和局限性子宫腺肌病的临床疗效  

A Comparison of Clinical Efficacy of High Intensity Focused Ultrasound Ablation(HIFU)for Diffuse and Localized Adenomyosis

作　　者：赵明阳 宋学薇 卢杰红 史丽坤 杨秀梅 贾凡 ZHAO Mingyang;SONG Xuewei;LU Jiehong;SHI Likun;YANG Xiumei;JIA Fan(Gynaecology,Cangzhou People’s Hospital,Cangzhou 061002,China)

机构地区：[1]河北省沧州市人民医院妇科,河北沧州061002

出　　处：《标记免疫分析与临床》2024年第7期1276-1280,共5页Labeled Immunoassays and Clinical Medicine

基　　金：河北省医学科学研究课题计划(编号:20232088)。

摘　　要：目的比较高强度聚焦超声(high intensity focused ultrasound,HIFU)治疗弥漫性和局限性子宫腺肌病的临床疗效。方法选取2017年10月至2021年2月在我妇科海扶治疗室接受HIFU治疗的子宫腺肌病患者60例,根据磁共振提示腺肌性质对患者进行分组,其中弥漫性30例和局限性30例,记录并比较两组治疗前、治疗后6个月、12个月症状严重程度评分(SSS)、痛觉视觉模拟评分(VAS)、月经失血图(PBAC)评分及健康相关生命质量评分(HRQL);评估治疗12个月消融效果,测定两组治疗前、治疗后12个月的性激素水平(FSH、LH、E_(2))、抗苗勒管激素(AMH)水平及窦卵泡(AFC)的变化况。计算两组临床疗效。结果两组患者在治疗前SSS评分、VAS评分、PBAC评分及HRQL评分差异均无统计学意义(P>0.05)。治疗后6个月及12个月两组SSS评分、VAS评分、PBAC评分均明显下降(P<0.05),HRQL评分明显增加(P>0.05)。但两组间差异无统计学意义(P>0.05)。局限性组病灶体积和NPV均明显小于弥漫性组,NPVR明显高于弥漫性组(P<0.05)。弥漫性组平均功率、治疗时间、辐照时间差异均明显高于局限性组(P<0.05)。两组患者治疗前FSH、LH、E_(2)、AMH、AFC水平差异均无统计学意义(P<0.05),两组治疗后FSH、LH、E_(2)均明显降低,AMH均明显增加,差异有统计学意义(P<0.05),而AFC差异无统计学意义(P>0.05)。弥漫性组总有效率为83.33%,局限性组总有效率为86.67%,两组患者总有效率差异无统计学意义(P<0.05)。结论HIFU治疗弥漫性和局限性子宫腺肌病的临床疗效相当。Objective To compare the clinical efficacy of high intensity focused ultrasound ablation(HIFU)in the treatment of diffuse and localized adenomyosis.Methods A total of 60 patients with adenomyopathy who received high intensity focused ultrasound(HIFU)treatment in the Haifu Treatment Room of Gynecology Department of our hospital from October,2017 to February,2021 were selected for the study.These patients were divided into two groups according to the properties of adenomyosis suggested by NMR,including:30 patients with diffuse type and 30 patients with limited type.Symptom severity score(SSS),visual analogue scale of pain(VAS),PBAC score of menstrual volume and health-related quality of life score(HRQL)of the two groups were recorded and compared before treatment,6 months and 12 months after treatment.The ablation effect was evaluated after 12 months of treatment,and sex hormone levels(FSH,LH,E_(2)),anti-mullerian hormone(AMH)levels and sinus follicle(AFC)of the two groups were measured before and after 12 months of treatment.The clinical efficacy of the two groups was then calculated.Results There were no significant differences in SSS score,VAS score,PBAC score and HRQL score between the two groups before treatment(P>0.05).At 6 and 12 months after treatment,SSS score,VAS score and PBAC score were significantly decreased(P<0.05),while HRQL score was significantly increased(P>0.05).There was no significant difference between the two groups(P>0.05).The lesion volume and NPV of the diffuse group were greater than the limited group,and NPVR value was lower than the limited group,with a statistical significance(P<0.05).The differences of average power,treatment duration and irradiation duration in diffuse group were significantly higher than those in limited group(P<0.05).There was no significant difference in levels of FSH,LH,E_(2),AMH and AFC between the two groups before treatment(P<0.05).After treatment,FSH,LH and E_(2) were significantly decreased,while AMH was significantly increased(P<0.05).There was no signific

关 键 词：弥漫性子宫腺肌病 局限性子宫腺肌病 高强度聚焦超声消融 临床疗效 

分 类 号：R711[医药卫生—妇产科学]