高强度聚焦超声消融治疗胎盘植入的疗效评价  

Evaluation of the Efficacy of High Intensity Focused Ultrasound Ablation in the Treatment of Placenta Accreta

作　　者：申旋 邓丹妮 任小玉 毕成群 SHEN Xuan;DENG Danni;REN Xiaoyu;BI Chengqun(Department of Gynecology,Guizhou Provincial People′s Hospital,Guiyang 550499,Guizhou,China)

机构地区：[1]贵州省人民医院妇科,贵州贵阳550499

出　　处：《系统医学》2025年第1期169-172,共4页Systems Medicine

摘　　要：目的探讨高强度聚焦超声消融(high-intensity focused ultrasound ablation,HIFUa)联合宫腔镜治疗有症状胎盘植入患者的临床效果。方法回顾性选取2015年8月—2024年1月贵州省人民医院收治的25例有症状的胎盘植入患者的临床资料,按治疗方法不同分为两组,14例患者给予宫腔镜病灶切除术治疗作为宫腔镜组,11例患者给予HIFUa联合宫腔镜病灶切除术治疗作为HIFUa+宫腔镜组。对比两组宫腔镜术中出血量、人绒毛膜促性腺激素(human choionic gonadotophin,HCG)转阴时间、月经恢复时间、经量减少发生率。结果宫腔镜组术中出血量为100(42.5,225)mL,多于HIFUa+宫腔镜组的20(10,100)mL,差异有统计学意义(Z=-2.50,P<0.05);两组患者术后HCG转阴时间、月经复潮时间比较,差异无统计学意义(P均>0.05)。宫腔镜组术后经量减少发生率为14.2%(2/14),HIFUa+宫腔镜组为18.1%(2/11),差异无统计学意义(χ^(2)=0.649,P>0.05)。结论HIFUa治疗胎盘植入安全有效,可减少宫腔镜术中出血,不影响术后HCG转阴及月经复潮时间,不增加术后月经量减少的风险。Objective To investigate the clinical effect of high-intensity focused ultrasound ablation(HIFUa)com⁃bined with hysteroscopy in the treatment of patients with symptomatic placenta accreta.Methods The clinical data of twenty-five patients with symptomatic placenta implantation admitted to Guizhou Provincial People′s Hospital from August 2015 to January 2024 were retrospectively selected as the research objects.According to different treatment methods,they were divided into two groups.Fourteen patients were treated with hysteroscopic lesion resection as the hysteroscopy group,and eleven patients were treated with HIFUa combined with hysteroscopic lesion resection as the HIFUa+hysteroscopy group.The amount of bleeding during hysteroscopy,the time of human choionic gonadotophin(HCG)turning negative,the time of menstrual recovery and the incidence of menstrual reduction were compared be⁃tween the two groups.Results The intraoperative blood loss in the hysteroscopic group was 100(42.5,225)mL,which was more than 20(10,100)mL in the HIFUa+hysteroscopic group,and the difference was statistically significant(Z=-2.50,P<0.05).There were no significant differences in HCG negative conversion time and menstrual recovery time between the two groups(all P>0.05).The incidence of postoperative menstrual volume reduction was 14.2%(2/14)in the hysteroscopy group and 18.1%(2/11)in the HIFUa+hysteroscopy group,and the difference was not statisti⁃cally significant(χ^(2)=0.649,P>0.05).Conclusion HIFUa is safe and effective in the treatment of placenta accreta,which can reduce the bleeding during hysteroscopy,does not affect the time of HCG negative conversion and men⁃strual recovery,and does not increase the risk of postoperative menstrual volume reduction.

关 键 词：胎盘植入 高强度聚焦超声消融 宫腔镜 临床结局 

分 类 号：R714.46[医药卫生—妇产科学]