多电极射频消融治疗子宫肌瘤的有效性及安全性初步研究

Preliminary study on multi-electrode radiofrequency ablation for uterine myoma efficacy and safety

目的探讨多电极高温对人子宫肌瘤组织作用的生物学效应和安全性,为多电极射频消融治疗子宫肌瘤提供实验依据。方法开腹病人暴露子宫,直视下将多电极针导入肌瘤体,应用伞径1.5cm的多电极射频针,设定消融温度75～95℃,10分钟消融子宫肌瘤20个,6分钟和5分钟各消融肌瘤5个。取材固定,光镜与电镜下观察消融组织变化以及检测消融全过程中宫旁血管区温度及病人体温。结果光镜及电镜均显示消融组织发生凝固性坏死,宫旁组织平均温度(36.9±1.4)℃,消融前后病人体温无差异性(P>0.05)。结论多电极射频消融作用于子宫肌瘤,引起一定范围的组织凝固性坏死,消融过程相对安全。其远期效果及安全性有待进一步临床观察。

Objective To explore biological efficacy and safety of multi-electrode radiofrequency ablation for human uterine myoma and to provide the basis for treatments of uterine myoma with RFA. Methods By using WE-7568 radiofrequency generator and multi-electrode needles（the diameter of expanded electrodes was 1. 5cm）,radiofrequency ablation was carried out in uterine myoma direct-visionaly under open surgery, radiofrequency energy was applied for 10 minutes in 20 myomas, six minutes and five minutes respectively in 5 myomas. Tissue specimens were resected and preserved in fixing liquid, Body temperature and temperature in paracervix were also monitored. Results Optical microscopic and electron microscopic analysis showed that the changes in ablation lesion was coagulation necrosis. The average temperature in paraceryix was 37.2±0.8℃ Patients body temperature had no prominent change during ablation （P〉O. 05）. Conclusion Multielectrode radiofrequency ablation can cause some range of coagulation necrosis of human uterine myoma. Treatment uterine myoma with RFA was relatively safe. But the efficacy and safety need to be observed in clinical practices.