高强度聚焦超声消融治疗子宫腺肌病合并子宫肌瘤的安全性及短期疗效评价

Evaluation on safety and short term efficacy of high intensity focused ultrasound ablation for treating adenomyosis coexisting with uterine leiomyomas

目的评价高强度聚焦超声(HIFU)单次消融治疗子宫腺肌病合并子宫肌瘤的安全性及短期疗效。方法收集2011年4月至2015年6月重庆医科大学附属第一医院海扶医院收治的45例子宫腺肌病合并子宫肌瘤患者临床资料。患者均一次性行HIFU消融治疗,评价术中及术后不良反应的发生率,术后MRI评估病灶消融率,随访术后1、3、6个月痛经及月经量过多改善情况。结果所有患者均顺利完成消融,术中及术后无严重并发症发生。腺肌病灶平均消融率为64.69%,肌瘤病灶平均消融率为77.66%。41例痛经患者术后1、3、6个月痛经疼痛数字评分法评分较术前显著下降,差异均有统计学意义(P<0.01);痛经完全缓解率分别为85.37%、80.49%、85.37%,部分缓解率分别为7.32%、14.63%、7.32%。26例月经量过多患者术后1、3、6个月缓解率分别为76.92%、73.08%、69.23%。结论 HIFU单次消融治疗子宫腺肌病合并子宫肌瘤安全、不良反应小,具有良好的短期疗效。

Objective To evaluate the safety and short-term efficacy of high intensity focused ultrasound（HIFU） single ablation for treating adenomyosis coexisting with uterine leiomyomas. Methods The clinical data in the patients with adenomyosis coexisting with leiomyomas underwent HIFU ablation in our hospital from April 2011 to June 2015 were collected. The pa-tients were performed the once HIFU ablation therapy. The occurrence rate of intraoperative and postoperative adverse reactions was evaluated. The lesion ablation rate was evaluated by postoperative MRI. The improvement situation of dysmenorrhea and men-orrhea at postoperative 1,3,6 months was followed up. Results All patients accomplished HIFU ablation without intraoperative and postoperative severe complications occurrence. The average ablation rates of adenomyosis and uterine fibroids lesions were64.69% and 77.66% respectively. The dysmenorrhea score at postoperative 1,3,6 months in 41 patients with dysmenorrhea was significantly decreased compared with before operation,the difference was statistically significant（P〈0.01）;the dysmenorrheal complete relief rates were 85.37%,80.49% and 85.37% respectively,the dysmenorrheal partially relief rates were 7.32%,14.63% and7.32%,respectively. The relief rates of 26 patients with menorrhagia at 1,3,6 months were 76.92%,73.08% and 69.23% respectively. Conclusion HIFU single ablation therapy has little adverse reactions and possesses better short term effect in treating adenomyosis coexisting with leiomyomas.