高强度聚焦超声治疗子宫肌瘤及腺肌症后妊娠结局的临床分析  

Effects of high-intensity focused ultrasound on pregnancy outcomes of uterine myoma and adenomyosis

作　　者：王纪元[1] 郭战坤[1] 张雪 杨欣[1] 李静 杨颖[1] 高双霞 WANG Jiyuan;GUO Zhankun;ZHANG Xue(Baoding Materal and Child Heath Hospital,Hebei,Baoding 071000,China)

机构地区：[1]河北省保定市妇幼保健院,071000 [2]河北省涿州市妇幼医院

出　　处：《河北医药》2024年第20期3128-3131,共4页Hebei Medical Journal

基　　金：保定市科技公关计划项目(编号:17ZF116)。

摘　　要：目的对有生育要求的子宫肌瘤及子宫腺肌症患者进行高强度聚焦超声(high intensity focused ultrasound,HIFU)消融治疗,分析其妊娠情况,探讨HIFU治疗对妊娠及结局的影响。方法选取2013年10月至2017年4月HIFU治疗有生育要求的子宫肌瘤及子宫腺肌症患者接受HIFU消融治疗的病史资料,回顾性分析子宫肌瘤患者治疗前后子宫大小、病灶体积及症状改善情况,分析子宫腺肌症患者治疗前后月经情况、痛经程度、病灶体积改变。选择术后妊娠的29例子宫肌瘤患者及16例子宫腺肌症患者的病史资料进行分析,了解其妊娠情况及结局。结果HIFU消融治疗后6个月,子宫肌瘤患者的子宫体积及子宫肌瘤体积较治疗前明显缩小,差异有统计学意义(P<0.05),患者的临床症状均有改善,且改善率较高;子宫腺肌症患者经期、经量、痛经评分、腺肌瘤体积均与治疗前相比均有明显改善,差异有统计学意义(P<0.05)。在45例妊娠患者中有41例成功分娩,胎儿的生长发育良好,无严重合并症及并发症。结论HIFU治疗子宫肌瘤及子宫腺肌症是有效的、安全的,不仅可以提高妊娠率,而且对妊娠及分娩均无明显不良影响,是伴有不孕的子宫肌瘤及子宫腺肌症患者的理想选择,临床上值得推广。Objective To investigate the effects of the high-intensity focused ultrasound(HIFU)on the pregnancy of patients with uterine fibroids and adenomyosis who have fertility requirements,and to investigate the effects of HIFU on the ongoing pregnancy.Methods From October 2013 to April 2017,outpatients with uterine fibroids and adenomyosis who had fertility requirements and treated with HIFU were included.Uterine size,lesion volume and symptoms improved of uterine fibroids before and after treatment of HIFU were retrospectively analyzed.The menstrual status,dysmenorrhea,lesion volume changes of uterine adenomyosis before and after treatment of HIFU were investigated.The clinical data of 29 patients with uterine fibroids and 16 cases of adenomyosis who got pregnant after HIFU were analyzed for their pregnancy and pregnant outcome.Results At 6 months of HIFU treatment,the uterine volume and uterine fibroids of patients with uterine leiomyoma were significantly smaller than those before treatment(P<0.05).The clinical symptoms were significantly improved with a high improvement rate.The menstrual period,menstrual flow,dysmenorrhea score,adenomyoma volume were significantly improved after treatment(P<0.05).In 45 cases of ongoing pregnancy,41 cases have been delivered successfully,with good fetal growth and development.Serious complications of pregnancy were not reported.Conclusion HIFU for treating uterine fibroids and adenomyosis is effective and safe that can improve the pregnancy rate without causing adverse events of pregnancy and childbirth.HIFU is an ideal choice for patients with uterine fibroids and adenomyosis who have fertility requirements,which is worthy of clinical promotion.

关 键 词：高强度聚焦超声 子宫肌瘤 子宫腺肌病 妊娠 

分 类 号：R737.33[医药卫生—肿瘤]