HIFU治疗子宫平滑肌瘤后腹壁水肿程度的影响因素  

Impact factors of abdominal wall edema degree after HIFU for uterine leiomyoma

作　　者：李俊书 王勇[3] 王李纲 王亮 潘长清 齐成秋 LI Junshu;WANG Yong;WANG Ligang;WANG Liang;PAN Changqing;QI Chengqiu(Department of Obstetrics and Gynecology,Mianyang Central Hospital,Mianyang Hospital Affiliated to School of Medicine,University of Electronic Science and Technology of China,Mianyang 621000,China;State Key Laboratory of Ultrasound in Medicine and Engineering,College of Biomedical Engineering,Chongqing Medical University,Chongqing 400016,China;Department of Ultrasound Diagnosis,Mianyang Central Hospital,Mianyang Hospital Affiliated to School of Medicine,University of Electronic Science and Technology of China,Mianyang 621000,China)

机构地区：[1]电子科技大学医学院附属绵阳医院·绵阳市中心医院妇产科,四川绵阳621000 [2]重庆医科大学生物医学工程学院,超声医学与工程国家重点实验室,重庆400016 [3]电子科技大学医学院附属绵阳医院·绵阳市中心医院超声科,四川绵阳621000

出　　处：《中国介入影像与治疗学》2025年第3期173-177,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：超声医学工程国家重点实验室开放课题项目(2022KFKT010)。

摘　　要：目的观察高强度聚焦超声(HIFU)治疗子宫平滑肌瘤(UL)后腹壁水肿程度的影响因素。方法回顾性分析128例接受HIFU的单发UL患者,根据T2WI所示水肿累及腹壁层次及皮下硬结程度将其分为Ⅰ、Ⅱ及Ⅲ度,比较患者一般资料、UL MRI特征、HIFU相关参数及不良反应,以无序多分类logistic回归分析筛选相关影响因素。结果腹壁水肿Ⅰ度79例(79/128,61.72%)、Ⅱ度27例(27/128,21.09%)、Ⅲ度22例(22/128,17.19%)。相比Ⅲ度,Ⅰ、Ⅱ度患者体质量指数(BMI)较小,Ⅰ度患者皮下脂肪层厚度及脂肪层+肌层厚度亦较小(校正P均<0.05);Ⅰ度患者中腹壁瘢痕占比低于Ⅱ度(校正P<0.05)。不同腹壁水肿程度之间HIFU前UL MRI表现及治疗参数差异均无统计学意义(P均>0.05)。BMI及腹壁瘢痕为区分HIFU后腹壁Ⅰ度与Ⅲ度水肿、BMI为区分Ⅱ度与Ⅲ度水肿的独立因素(P均<0.05)。结论BMI及腹壁瘢痕是HIFU治疗UL后腹壁水肿程度的影响因素。Objective To observe the impact factors of abdominal wall edema degree after high intensity focused ultrasound(HIFU)ablation for uterine leiomyoma(UL).Methods Totally 128 patients with solitary UL who underwent HIFU were retrospectively enrolled.Edema degree of abdominal wall showed on T2WI were classified into gradeⅠ,ⅡandⅢaccording to the involved layers and subcutaneous indurations.Patients’general data,MRI characteristics of UL,HIFU parameters and adverse reactions were compared among grades.Multinomial logistic regression analysis was used to screen the impact factors of edema degree.Results Among 128 patients,gradeⅠedema was found in 79 cases(79/128,61.72%),while gradeⅡandⅢwere observed in 27(27/128,21.09%)and 22(22/128,17.19%)cases,respectively.Compared with patients with gradeⅢedema,those with gradesⅠandⅡhad lower body mass index(BMI),and patients with gradeⅠedema had decreased subcutaneous fat thickness and decreased total thickness of subcutaneous fat and muscle layers(both adjusted P<0.05).The proportion of abdominal scars in patients with gradeⅠedema was lower than that with gradeⅡ(adjusted P<0.05).No significant difference of MRI findings of UL before HIFU nor HIFU parameters was noticed among different grades of edema(all P>0.05).BMI and abdominal scar were both impact factors for distinguishing gradeⅠandⅢ,while BMI was the impact factor for distinguishing gradeⅡandⅢedema after HIFU for UL(all P<0.05).Conclusion BMI and abdominal scar were both impact factors for abdominal wall edema degree after HIFU for UL.

关 键 词：子宫肿瘤 平滑肌瘤 高强度聚焦超声消融 磁共振成像 

分 类 号：R737.33[医药卫生—肿瘤] R445.2[医药卫生—临床医学]