高强度聚焦超声治疗子宫肌瘤疗效分析

Analysis of the effectiveness on high intensity focused ultrasound in treating hysteromyoma

目的:评价高强度聚焦超声(HIFU)治疗子宫肌瘤的疗效及安全性。方法:对拒绝手术要求保留子宫,或因高危因素手术有风险的单发或多发性子宫肌瘤患者51例,超声定位实时监视下,从体外将高能量超声聚焦于子宫肌瘤内,应用JC型高强度聚焦超声肿瘤治疗系统进行HIFU治疗。治疗后定期随访观察患者临床症状、体征及瘤体超声影像学变化,同时对疗效作出评估。结果:子宫肌瘤直径1cm^9cm,高强度聚焦超声的时间1h^5h。海扶刀治疗1~6月后,B超检查肌瘤回声增强,肌瘤血流明显减少:患者月经过多,经期延长,症状均明显改善:磁共振(MRI)提示,肌瘤边界模糊,肌瘤明显缩小。51例患者HIFU治疗后近期总有效率为88.23%(疗效显著31例、有效14例),无效6例(11.77)%。结论:HIFU体外热疗治疗子宫肌瘤安全有效,可作为一种无手术创伤治疗子宫肌瘤的新方法。

Objective： To evaluate the efficacy and safety of high intensity focused ultrasound （ HIFU）in the treatment of hysteromyoma. Methods： JC - HIFU was applied on the patients rejecting operation and demanding reserving uterus, or patients with high operative risk, 51 cases of single or multiple hysteromyoma were treated with HIFU. In the process of treatment, real - time two - dimensional ultrasonography was used to guide the location of the focal field and monitor the ablating procedure. After treatment, the clinical symptoms, signs and ultrasonographic changes were observed periodically, and the efficacy of HIFU was evaluated. Results： Hysteromyoma with diameter between lcm to 9cm were treated by HIFU for 1h - 5 h. Among 1 - 6 months after HIFU treatment, B ultrasound exam showed an enhanced echo with obviously reduced blood flow. Symptoms like menometrorrhagia and bradymenorrhea were obviously relieved. MRI indicated that the boundary of hysteromyoma was blurred and the size obviously diminuated. Among 51 cases, the total effective power was 88.23 % ; 31 cases achieved significant curative effect; 14cases,mederate curative effect; and 6 cases failed to respond to the treatment. Conclusion： Patients with hysteromyoma can be treated with HIFU safely and effectively, and HIFU appears to be a now non- invasive method for the treatment of hysteromyoma.