超声引导下自凝刀治疗子宫肌瘤的疗效及声像图分析

Ultrasound Guided Auto-coagulation Tome for Treatment of Hysteromyoma

目的探讨超声引导下经阴道自凝刀治疗子宫肌瘤的声像图改变及疗效。方法经超声检查诊断肌瘤98例,共124个结节,进行单次或分点多次凝固治疗。对比术前、术后患者的声像图改变及临床症状的变化。结果壁间肌瘤治疗过程中,结节回声增强,直至覆盖整个病灶。术后结节以不均质较强回声为主。治疗结束后全部结节均缩小20%～28%;黏膜下肌瘤消失。随访半年,所有壁间肌瘤结节继续缩小达80%以上。一年后检查,被治疗过的结节无一例复发。CDFI显示治疗后肿瘤血供消失。结论超声引导下自凝刀经阴道治疗子宫肌瘤可有效灭活<5.5cm壁间肌瘤和清除黏膜下肌瘤。超声担负着术前诊断、术中引导、术后判断疗效的重要作用。

Objective The purpose of our study was to investigate ultrasound guided auto-coagulation tome for transvaginal treatment of hysteromyoma and to discuss the changes on sonograms and the therapeutic effects.Methods A total 98 patients with hysteromyomas (124 nodes) diagnosed by ultrasound underwent single or multiple and multi-pointed coagulation necrosis operations.The changes of clinical symptoms and sonograms were compared before and after the treatment.Results Under the treatment of the intramural myomas the echoes of the nodes were strengthened,till covered the whole foci.The node echoes became stronger and stranger.At the end of the treatment,all of the nodes shrank 20%~28%.The submucous myomas disappeared after treatment.Six months later,the intramural hysteromyomas shrank at least 80%.After one year follow-up,all the nodes in the treated patients had no recurrences.CDFI showed the blood supply to the original myomas disappeared.Conclusions Ultrasound guided auto-coagulation tome (radio-frequency coagulation ablation) can deactivate the intramural myoma less than 5.5 cm and can extinguish submucous myomas.Ultrasound imaging was used for diagnosis before operation,for guiding during operation,and for judging the effects of treatment.