子宫动脉栓塞术与高强度聚焦超声治疗巨大子宫肌瘤的疗效比较

Comparison on curative effect of UAE and HIFU in the treatment of giant uterine fibroids

目的比较子宫动脉栓塞术(uterine arterial embolization,UAE)和高强度聚焦超声(high mtensity focused ultrasound,HIFU)治疗巨大子宫肌瘤(最大线径≥7 cm)的疗效。方法回顾性分析在笔者所在医院就诊的135例巨大子宫肌瘤患者,按照适应证和患者意愿分组,UAE组57例,HIFU组78例。比较2组患者:治疗前后最大子宫肌瘤体积变化、并发症发生率、中远期复发率、妊娠结局。结果治疗后3个月,2组患者最大肌瘤体积均明显减小(P<0.05),组间比较无显著差异(P>0.05);2组并发症发生率无显著差异(P>0.05);UAE组治疗后1年内和2年内的复发率均低于HIFU组(P<0.05);对于2组患者中有生育意愿者,UAE组妊娠率和活产率低于HIFU组(P<0.05)。结论对于巨大子宫肌瘤患者,若患者无生育意愿,宜采用UAE;否则,宜行HIFU治疗。

Objective To compare the effects of uterine arterial embolization focused ultrasound （HIFU） to treat giant uterine fibroids. Methods A total of 135 fibroids were selected in Suizhou central hospital. All the patients were divided into （ P 2 UAE） and high intensity atients with giant uterine groups according to the indications and patients＇ intention,57 cases as UAE group and 78 cases as HIFU group. The volume of maximal myoma,complications of treatment,postoperative recurrence and pregnancy outcome after treatment of patients of 2 groups were compared. Results After 3 months of treatment,there was no significant difference in the volume of the maximal fibroids between the 2 groups （P〉0.05）,which was significantly reduced compared with the previous treatment（P〈0.05）. There was no significant difference in the incidence of complications（P〉0.05〉. The recurrence rate 1 year and 2 years after treatment was lower than that in the HIFU group （all,P〈0.05）. For the two groups of patients,the pregnancy rate and the live-birth rate of the UAE group were lower than that in the HIFU group （all, P〈0.05）. Conclusion who has no desire to have For patients with giant uterine fibroids,the UAE should be adopted for the patient children. Otherwise,it is advisable to be treated with HIFU