高强度聚焦超声引起子宫肌瘤患者盆底功能损伤的风险因素  

Risk Factors Study for Pelvic Floor Dysfunction Induced by High-Intensity Focused Ultrasound in Patients with Uterine Fibroids

作　　者：朱惠欢[1] 孙昌莲 阳丽君[2] 陈海燕[1] 刘晓真[1] ZHU Hui-Huan;SUN Chang-Lian;Yang Li-Jun(Ultrasound Imaging Department,Zhongshan People's Hospital,Zhongshan 528400,Guangdong,China)

机构地区：[1]中山市人民医院超声影像科,广东中山528400 [2]中山市人民医院妇科,广东中山528400

出　　处：《吉林医学》2025年第4期817-821,共5页Jilin Medical Journal

基　　金：中山市社会公益科技研究项目[项目编号:2022B1116]。

摘　　要：目的:探究高强度聚焦超声(HIFU)治疗引起子宫肌瘤患者盆底功能损伤的风险因素。方法:回顾性选取接受HIFU治疗的190例子宫肌瘤患者,比较患者治疗前后盆底超声参数变化。另根据治疗后盆底损伤情况分为未损伤组(n=160)和损伤组(n=30),比较两组临床资料及HIFU消融参数,采用多因素Logistic回归分析盆底功能损伤的独立危险因素。结果:治疗后,在静息、Valsalva动作及缩肛三种状态下患者矢状位膀胱颈位置较治疗前均显著增大,而盆膈裂孔面积、盆膈裂孔横径较治疗前均显著减小(P<0.05);且Valsalva动作状态下的膀胱尿道后角较治疗前显著增大(P<0.05)。多因素分析显示,肿瘤体积≥65 cm^(3)、辐照时间≥600 s、辐照能量≥150 kJ、治疗强度≥400 s/h及肌瘤体积消融率≥75%均是盆底功能损伤的独立危险因素(P<0.05)。结论:肿瘤体积、辐照时间、辐照能量、治疗强度、肿瘤体积消融率是HIFU治疗子宫肌瘤患者盆底功能损伤的高风险因素。Objective To explore the risk factors of pelvic floor function injury caused by HIFU treatment in patients with uterine fibroids.Methods A total of 190 patients with uterine fibroids who received HIFU treatment in our hospital from February 2022 to June 2024 were retrospectively selected for analysis,and the changes in pelvic floor ultrasound parameters before and after treatment were compared.According to the pelvic floor injury after treatment,the patients were divided into the uninjured group(n=160)and the injured group(n=30).The two groups'clinical information and HIFU ablation parameters were contrasted,and multivariate logistic analysis was used to examine the independent risk factors for pelvic floor functional damage.Results The findings showed that the area and transverse diameter of the diaphragmatic hole decreased after treatment,with the difference being statistically significant(P<0.05),the position of the bladder neck in the sagittal position during resting,Valsalva Maneuver,and anal shrinkage of 190 patients with uterine fibroids increased after treatment.In the Valsalva Maneuver state,the posterior vesicourethral angle was also higher than it was before therapy,and the difference was statistically significant(P<0.05).Multivariate analysis showed that tumor volume≥65 cm^(3),irradiation time≥600 s,irradiation energy≥150 kJ,treatment intensity≥400 s/h,and fibroid volume ablation rate≥75%were all independent risk factors for pelvic floor functional injury(OR=5.981,7.312,7.828,15.194,6.592,P<0.05).Conclusions Tumor volume,irradiation time,irradiation energy,treatment intensity,and tumor volume ablation rate are high-risk factors for pelvic floor function injury in HIFU treatment of uterine fibroids.

关 键 词：子宫肌瘤 高强度聚焦超声 盆底功能损伤 

分 类 号：R737.33[医药卫生—肿瘤]