六氟化硫微泡在HIFU治疗T2WI高信号子宫肌瘤中的临床应用

Application of Sulfur Hexafluoride Micro-bubble in the Treatment of T2WI High Signal Uterine Fibroids with High Intensity Focused Ultrasound

目的探讨六氟化硫微泡在高强度聚焦超声治疗T2高信号子宫肌瘤中的应用价值.方法选取昆明医科大学第一附属医院36例单发T2高信号子宫肌瘤患者随机分成研究组和对照组,对照组18例患者术中不用六氟化硫微泡,研究组18例患者术中使用六氟化硫微泡.分别记录2组的手术时间(min)、出现块状灰度变化时间(s)、辐照时间(s)、治疗剂量(J),并发症发生的情况及消融率(%).结果研究组手术时间、出现块状灰度变化时间(s)、辐照时间(s)、治疗剂量分别为(101.51±43.02)min,(856.42±451.14)s,(1077.37±546.23)s,(496 581.81±267 192.31)J,对照组分别为(261.34±85.53)min,(1 833.32±642.67)s,(1 890.21±1 268.43)s,(784 608.31±357 621.45)J,2组各参数相比差异有统计学意义(P<0.05).研究组消融率为83.3%,对照组消融率为55.5%,2组参数相比差异有统计学意义(P<0.05).研究组患者出现全身麻木1例,没有发生治疗区皮肤烧伤.对照组治疗区皮肤Ⅱ°烧伤1例,全身麻木2例,并发症的发生率为1/18(5.5%),2组均未出现肠穿孔、膀胱穿孔等严重并发症.结论六氟化硫微泡在高强度聚焦超声热消融T2高信号子宫肌瘤中可缩短手术时间,减少并发症,提高消融率,在临床中发挥着重要的应用价值.

Objective To evaluate clinical value of ultrasound contrast agent the sulfur hexafluoride micro-bubble in the treatment of T2WI high signal uterine fibroids with high intensity focused ultrasound （HIFU） . Methods A total of 36 patients with T2WI high signal uterine fibroids were randomly divided into experimental group and control group. Eighteen patients in experimental group received HIFU treatment with sulfur hexafluoride micro-bubble before, during and after the operation while another eighteen in control group received HIFU treatment with sulfur hexafluoride micro-bubble only after the operation. We recorded operation time （min） , changing time of massive gray （s） , irradiation time （s） , therapeutic dose （J） , incidence of complications and ablation rate （%） . Results Operation time, changing time of massive gray, irradiation time, and therapeutic dose in experimental group were （lO1.51 ± 43.02） min, （856.42 ± 451.14） s, （1 077.37 ± 546.23） s, and （496581.81 ± 267192.31 ） J, respectively while those in control group were （261.34± 85.53） rain, （1 833.32 ±642.67） s, （1 890.21 ± 1 268.43） s, and （784 608.31 ±357 621.45） J, respectively. Significant differences were found among those parameters between the two groups （P 〈0.05） Tumor ablation rate in experimental group was 83.3% while that in control group was 55.5%, which was of significant difference betweenthe two groups （P〈O.05） . One case of muscular stiffness was found in experimental group while one case of second-degree burn and two cases of muscular stiffness were found in the control group .The incidence of complications was 1/18 （5.5%） . No severe complication like bowel perforation or bladder perforation was found in the two groups. Conclusion The effect of ultrasound contrast agent sulfur hexafluoride micro-bubble can shorten operation time, improve tumor ablation rate and reduce complications and it can play a guiding role in clinical work.