海扶刀与子宫切除术治疗子宫肌瘤疗效比较

Comparison on effects of high intensity focused ultrasound and abdominal hysterectomy for treating uterine fibroids

目的对比研究海扶刀与子宫切除术治疗子宫肌瘤的利弊。方法将167例症状性子宫肌瘤患者分为海扶刀治疗组(n=86)和子宫切除术组(n=81)。治疗前及术后1、3、6个月分别记录不良事件,进行子宫肌瘤症状-生活质量问卷(UFSQOL)调查,应用健康状况调查问卷简表-36(SF-36)评估健康相关生活质量。结果两组均无严重不良事件发生。海扶刀治疗组临床并发症及不良事件低于子宫切除术组,UFS-QOL得分优于子宫切除术组,术后1个月SF-36得分优于子宫切除术组,但术后3、6个月SF-36得分差异没有统计学意义(P>0.05)。结论不能耐受手术或希望保存子宫及其生理功能的患者适合海扶刀治疗。

Objective To compare the advantages and disadvantages of high intensity focused ultrasound （HIFU ） and total abdominal hysterectomy for the treatment of uterine fibroids .Methods 167 patients with symptomatic uterine fibroids were divid‐ed into the HIFU treatment group（n=86） and the hysterectomy group（n=81） .The adverse events were recorded before operation and at postoperative 1 ,3 ,6 months .The questionnaire survey of the uterine fibroid symptoms‐quality of life （UFS‐QOL） was con‐ducted .The health related living quality was evaluated by using the health survey questionnaire‐36（SF‐36） .Results There were no severe adverse events in either group .The significant clinical complications and adverse events in the HIFU group were lower than those in the hysterectomy group .The UFS‐QOL scores in the HIFU group were superior to those in the hysterectomy group ,but the SF‐36 scores at postopertive 3 ,6 months had statistically significant differences between the two groups （P〉0 .05） .Conclusion The patients who are unable to tolerate surgery or hope to preserve the uterus and its physiological function are suitable for HI‐FU treatment .