超声消融治疗对不同部位子宫肌瘤消融率及瘤体大小的影响

Effects of ultrasound-guided focused ultrasound ablation on the ablation rate and size of the tumors for patients with different uterine fibroids

目的:探讨超声消融治疗对不同部位子宫肌瘤消融率及瘤体大小的影响。方法:选取2014年1月至2015年1月收入我院妇产科的子宫肌瘤患者83例为研究对象,根据肌瘤类型分为浆膜下肌瘤组、黏膜下肌瘤组和肌壁间肌瘤组,采用磁共振成像(MRI)检测患者的肌瘤消融率及瘤体大小变化,采用症状严重程度(SSS)评分表评价患者的临床症状。结果:83例子宫肌瘤患者共111个肌瘤,其中浆膜下肌瘤组38例57个(51.3%),黏膜下肌瘤组29例36个(26.1%),肌壁间肌瘤组16例18个(16.2%)。浆膜下肌瘤组患者的消融率低于黏膜下肌瘤组和肌壁间肌瘤组,但差异无统计学意义(P>0.05)。治疗后6及12个月,黏膜下肌瘤组患者的肌瘤体积缩小率显著高于浆膜下肌瘤组和肌壁间肌瘤组,差异具有统计学意义(P<0.05);而浆膜下肌瘤组和肌壁间肌瘤组比较,差异无统计学意义(P>0.05)。与治疗前比较,治疗后6及12个月3组患者的SSS评分均显著降低,差异具有统计学意义(P<0.05)。3组患者的不良反应比较,差异无统计学意义(P>0.05)。结论:超声消融治疗对浆膜下、黏膜下和肌壁间肌瘤患者具有较好的治疗效果,能够显著改善患者的临床症状,减小肌瘤体积,取得较高的肌瘤消融率,为子宫肌瘤患者提供了新的治疗手段。

Objective： To discuss the effects of ultrasound-guided focused ultrasound ablation（ US-FUA） on the ablation rate and size of the tumors for patients with different uterine fibroids. Methods： From January 2014 to January 2015,83 patients were selected for this study in our hospital and the patients were divided into subserosal fibroids group,submucous fibroid group and intramural fibroid group according to the types of tumors. The ablation rate and size of tumors were examined by magnetic resonance imaging（ MRI） and the clinical symptoms of patients were assessed by severity of symptom scale（ SSS）. Results： 111 symptomatic fibroids were observed among the 83 patients. 38 patients with 57 subserosal fibroid（ 51. 3%） were in subserosal fibroid group,29 patients with 36 submucous fibroid（ 26. 1%） were in submucous fibroid group,16 patients with 18 intramural fibroid（ 16. 2%）were in intramural fibroid group. The ablation rate of subserosal fibroid group was much lower than the other two groups,but the difference was not significant（ P 0. 05）. The ablation rate of tumor in submucous fibroid group was significantly higher than that in the subserosal fibroid and intramural fibroid groups（ P 0. 05） after 6 and 12 months treatment. But no statistical difference of the ablation rate of tumor was observed between subserosal fibroid group and muscle intramural fibroid group（ P 0. 05）. The clinical symptoms of three groups with SSS scores were significantly decreased after 6 and 12 months treatment（ P 0. 05）. The difference of side effects among three groups was not significant（ P 0. 05）. Conclusion： US-FUA is effective for the patients with different uterine fibroids and it can improve the clinical symptoms of patients,reduce fibroid tumor volume and obtain high fibroids ablation rate. So it is a new choose for patients with uterine fibroids.