高强度聚焦超声消融术治疗围绝经期子宫肌瘤的效果及腹壁损伤影响因素分析

The effects of high intensity focused ultrasound on patients with uterine myoma in perimenopause and the influence factors of abdominal injuries after the treatment

目的分析高强度聚焦超声(high intensity focused ultrasound,HIFU)消融治疗围绝经期子宫肌瘤的临床效果及腹壁损伤的相关影响因素。方法选取2012年9月至2014年9月在深圳市龙华新区人民医院妇科诊治的50例围绝经期子宫肌瘤患者为研究对象。均予以HIFU消融治疗,对治疗效果及并发症发生情况进行回顾性分析评价。结果治疗后MRI增强扫描提示肌瘤的消融率超过50%。治疗3个月后患者围绝经期、子宫肌瘤临床症状均较治疗前明显改善(P<0.05),肌瘤平均体积显著低于治疗前(P<0.05)。发生皮肤损伤并发症患者的辐照时间、治疗总能量消耗均显著多于无并发症者(P<0.05),但单位投射时间、肌瘤后缘至前腹壁的距离无显著性差异(P>0.05)。结论 HIFU消融治疗围绝经期子宫肌瘤疗效值得肯定;其治疗后常见并发症——腹壁损伤与辐照时间、治疗总能量呈正相关性。

Objective To study the effects of high intensity focused ultrasound on patients with uterine myoma in perimenopause and the influence factors of abdominal injuries after the treatment. Methods 50 cases of patients with uterine myoma in perimenopause in our hospital between September 2012 to September 2014 were selected randomly as the research targets. All the cases were treated with HIFU ablation,and the treatment effect and complications were analyzed retrospectively. Results The ablation rate of MRI enhanced after treatment was more than 50%. After 3 months of treatment,the clinical symptoms of peri-menopausal and uterine fibroids were significantly improved（ P〈0. 05）,and the average volume of myoma was significantly lower than that before treatment（ P〈0. 05）. Occurrence skin injury complications in patients with the irradiation time,treatment of total energy consumption were significantly higher than those in the no complications（ P〈0. 05）,but at a distance from the unit time projection,the trailing edge of the myoma prior to the abdominal wall no significant difference（ P〉0. 05）. Conclusions HIFU ablation treatment of uterine fibroids in the treatment of uterine fibroids is worthy of recognition; the treatment of common complications after the abdominal wall injury and irradiation time,the total energy of the treatment was positively correlated.