高强度聚焦超声消融治疗60例有症状子宫肌瘤的临床观察

The clinical efficacy of high-intensity focused ultrasound ablation(HIFUA) for the treatment of symptomatic uterine fibroid

目的探讨高强度聚焦超声消融(high-intensity focused ultrasound ablation,HIFUA)治疗子宫肌瘤的临床疗效。方法选择2012年4月至2014年12月在武汉市江夏区第一人民医院就诊的60例有症状的子宫肌瘤患者,在超声引导下采用HIFUA技术治疗,比较患者术后临床症状改善情况和肌瘤体积变化。结果术后12个月复查,平均临床症状评分[(14.32±2.35)分]低于术前[(20.53±6.06)分],(P<0.05),临床症状改善率(68.03±14.92)%;肌瘤平均体积[(4.92±2.35)cm^3]小于术前[(6.53±2.36)cm^3],(P<0.05),肌瘤体积缩小率(78.23±14.94)%。患者治愈率45.68%,显效率38.27%,总有效率95.06%,无效率4.94%。结论超声引导下HIFUA治疗有症状的子宫肌瘤安全有效、创伤小、远期并发症少,是微创技术治疗有症状的子宫肌瘤的一种新方法。

Objective To explore the clinical efficacy of high-intensity focused ultrasound ablation （ HIFUA） for the treatment of symptomatic uterine fibroid .Methods 60 patients with symptomatic uterine leiomyomas treated in The First People＇s Hospital of Jiangxia District from April 2012 to December 2014 were selected .They were treated by the HIFUA therapy under ultrasound guidance.The situation of clinical symptoms and changes of fibroid volume were compared after surgery .Results The mean preoperative clinical symptom score （20.53 ±6.06） was higher than the average postoperative clinical symptom score （14.32 ±2.35） . The difference was statistically significant （ P〈0.05 ） .The rate of clinical symptom improvement was （ 68.03 ±14.92 ）%.Average fibroid volume 12 months after surgery [ （ 4.92 ±2.35 ） cm3 ] was smaller than preoperative volume [ （ 6.53 ±2.36 ） cm3 ] .The difference was statistically significant （ P〈0.05 ） .The reduced ratio of fibroid volume was （ 78.23 ±14.94 ）%.The cure rate was 45.67%.The effective rate was 46.91%.Total effective rate was 95.06% with 4.94% inefficiency ..Conclusion Ultrasound guided HIFUA is safe and effective for the treatment of symptomatic uterine fibroid , with little trauma and less complications .It’s a new method of minimally invasive technique for the treatment of symptomatic uterine fibroid .