高强度聚焦超声治疗子宫肌瘤对卵巢功能的影响

Study of Influence on Ovarian Function by HIFU and Surgical Treatment for Uterine Fibroids

目的探讨高强度聚焦超声(HIFU)治疗子宫肌瘤对卵巢功能的影响。方法选择2008年1月至2010年12月在本院就诊的90例子宫肌瘤患者为研究对象,按照治疗方式不同将其分为HIFU组(n=30,HIFU治疗),肌瘤剔除组(n=30,子宫肌瘤剔除术)和全子宫切除组(n=30,全子宫切除术)。测定并分析3组患者术前及术后6个月血清卵泡刺激素(FSH)、黄体生成素(LH)和雌二醇(E2)水平变化(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,并与之签署临床研究知情同意书)。3组患者年龄、临床症状及肌瘤类别方面比较,差异无统计学意义(P>0.05)。结果 HIFU组和肌瘤剔除组患者术前与术后6个月血清FSH,LH,E2比较,差异无统计学意义(P>0.05)。全子宫切除组患者术后6个月血清FSH,LH明显升高,E2明显下降,与术前相比,差异有统计学意义(P<0.05)。HIFU组与全子宫切除组术后6个月激素水平变化比较,差异有统计学意义(P<0.05)。结论 HIFU治疗育龄期子宫肌瘤患者对卵巢功能无明显影响。

Objective To explore the influence on ovarian function by HIFU, myomectomy, and hysterectomy for uterine fibroids. Methods From January 2008 to December 2010,90 women with uterine fibroids were included in the study, and divided into high intensity focused ultrasound （HIFU）group （n =30）, myomectomy group（n：30） and hysterectomy group（n=30） according to treatment method. Measure and compare the serum follicle-stimulating hormone （FSH）,luteinizing hormone（LH）and estradiol hormone （E2） level changes at 6 months before and after treatment. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Futian People＇s Hospital of Shenzhen. Informed consent was obtained from each patient. There has no significant differences between ages, clinical symptom and clinical classification among three groups （P 〉 0. 05）. Results No significant difference was found in hormone levels between preoperative and 6 months after treatment in HIFU group and myomectorny group. 6 months after hysterectomy, FSH, LH increased and E2 decreased which were significant differences compared to preoperative（P〈0. 05）. There had significant differences of hormone level change between HIFU group and hysterectomy group in 6 months after treatment. Conclusions HIFU treatment for childbearing age women with uterine fibroids does not influence the ovarian function.