HIFU治疗子宫腺肌病142例的临床疗效分析(附12例妊娠病例)

Analysis of the Efficacy of High Intensity Focused Ultrasound in the Treatment of 142 Cases of Adenomyosis(12 Cases of Pregnancy)

目的:评价高强度聚焦超声(high intensity focused ultrasound,HIFU)治疗子宫腺肌瘤的临床疗效及安全性。方法:选取2007年12月～2012年12月在我院行HIFU治疗的142例子宫腺肌病患者,治疗后连续1、3、6、12个月随访,评价患者病灶的超声影像学变化及临床症状的改善情况。结果:治疗后,有效随访118例,彩超检查显示治疗后第1个月子宫体积平均缩小35%,第3个月缩小59%,第6个月缩小85%,第12个月缩小80%。110例经量增多的子宫腺肌病患者中,3例在治疗后12个月经量恢复正常水平,45例在治疗后12个月经量明显减少,基本恢复正常值,68例在治疗后12个月经量较治疗前明显减少,但仍高于正常值;2例在治疗后12个月经量变化不大,总有效率为98.3%。118例痛经的子宫腺肌病患,34例在治疗后随访的12个月内痛经消失,80例在治疗后随访的12个月内仍有轻度痛经,4例在治疗后随访的12个月内仍有中度以上痛经,总有效率为96.6%。随访过程中发现12例再妊娠病例。结论:HIFU治疗子宫腺肌病具有安全,有效,并发症少的特点,且不影响患者妊娠,能够满足患者保留子宫、再生育的需求,可作为一种无创治疗子宫腺肌病的有效治疗方法。

Objective： To evaluate the efficacy and safety of high-intensity focused ultrasound （HIFU） in the treatment of adeno- myosis. Methods： 142 cases of adenomyosis admitted in our hospital from December 2007 to December 2012 were treated by HIFU and followed-up for 1, 3, 6 and 12 months, and the improvement of ultrasonic imaging changes and clinical syptoms were evaluated. Results： After treatment, 118 cases were effectively followed up. Color Doppler ultrasound showed that the average of decrease of uterine volume was 35% after 1 month＇s treatment, 59% after 3 months＇ treatment, 85% after 6 months＇ treatment, 80% after 12 months＇ treatment. In 110 cases of adenomyosis with menorrhagia, 3 cases returned to normal after 12 months＇ treatment, 45 cases decreased significantly, 68 cases decreased but were still higher than normal, 2 cases had little change, the total effective rate was 98.3%. In 118 cases of adenomyosis with dysmenorrhea, dysmenorrhea disappeared wi^in 12 months in 34 cases, 80 cases still had mild dysmenorrhea, 4 cases still had mod- erate and severe dysmenorrhea, the total effective rate was 96.6%. Re-pregnancy was found in 12 cases Conclusion： HIFU was safe and effective in the treatment of adenomyosis with few complications, which had little impact on the pregancy and could meet the need of re-pregnancy and preservation of uterus of patients.