高强度聚焦超声消融子宫腺肌病灶对子宫内膜及卵巢功能的影响  

Effects of high-intensity focused ultrasound ablation of adenomyosis on endometrial and ovarian function

作　　者：王明敏 潘姿璇 WANG Mingmin;PAN Zixuan(Department of Obstetrics and Gynecology,Shandong Second Medical University,Weifang 261053,China;Department of Obstetrics and Gynecology,Shouguang People's Hospital;Department of Obstetrics and Gynecology,Affiliated Hospital of Shandong Second Medical University)

机构地区：[1]山东第二医科大学妇产科学教研室,山东潍坊261053 [2]寿光市人民医院妇科 [3]山东第二医科大学附属医院妇一科

出　　处：《山东第二医科大学学报》2025年第1期56-60,共5页Journal of Shandong Second Medical University

基　　金：潍坊市科技发展计划项目(项目编号:2020YX033)。

摘　　要：目的 通过研究高强度聚焦超声(HIFU)消融子宫腺肌病灶后对在位子宫内膜、子宫血供及卵巢功能的影响,了解该方案的安全性,并进一步探讨其对生育力的影响。方法 80例子宫腺肌病患者分为观察组(HIFU治疗组)和对照组(子宫切除组)各40例。两组均子宫内膜取材后行慢性子宫内膜炎、子宫内膜腺体数及子宫内膜微血管数数据收集并进行分析。观察组患者治疗前后分别通过检测子宫动脉动力学指标和女性基础性腺激素水平评估子宫血流灌注情况及卵巢功能是否受到影响。结果 两组病例慢性子宫内膜炎症、子宫内膜腺体数量及子宫内膜微血管密度差异均无统计学意义(P>0.05);观察组治疗前后子宫动脉血流参数和卵巢功能变化无统计学意义(P>0.05)。结论 HIFU治疗宫腺肌病后未增加慢性子宫内膜炎的发生,未明显造成腺体数量减少及微血管密度改变,未明显影响子宫血流灌注情况,对卵巢功能无明显损伤,体现出HIFU治疗的安全性,提示该治疗方式未对女性生育力造成不良影响。Objective The aim of this study was to explore the effects of high-intensity focused ultrasound(HIFU)ablation on the adjacent endometrium,uterine blood supply,and ovarian function in patients with adenomyosis.By doing so,the safety of this approach could be evaluated,and its potential influence on fertility could be further investi-gated.Methods Eighty patients diagnosed with adenomyosis were randomly allocated into an observation group(receiv-ing HIFU treatment)and a control group(undergoing hysterectomy),with 40 patients in each group.Endometrial sam-ples were collected from both groups,and relevant data such as the occurrence of chronic endometritis,the count of endo-metrial glands,and the microvascular density of the endometrium were gathered and analyzed.In the observation group,the dynamic parameters of the uterine artery and the levels of female basal gonadal hormones were assessed before and after treatment to evaluate the impact on uterine blood flow and ovarian function.Results There were no statistically sig-nificant differences between the two groups in terms of chronic endometritis,endometrial gland counts,and endometrial microvascular density(P>0.05).Moreover,no significant alterations were observed in the uterine artery blood flow pa-rameters or ovarian function in the observation group before and after treatment(P>0.05).Conclusion HIFU treatment for uterine adenomyoma did not lead to an increased incidence of chronic endometritis,nor did it cause a remarkable re-duction in the number of glands and microvascular density.It did not significantly affect uterine blood perfusion and did not cause obvious damage to ovarian function.These findings demonstrate the safety of HIFU treatment,implying that this treatment modality has not exerted a negative impact on female fertility.

关 键 词：子宫腺肌病 高强度聚焦超声 子宫内膜 

分 类 号：R711.74[医药卫生—妇产科学]