高强度聚焦超声消融术对子宫肌瘤合并高血压患者的影响研究

Impact of High-intensity Focused Ultrasound Guided Ablation on Uterine Fibroids Patients Merged with Hypertension

目的探讨高强度聚焦超声(HIFU)消融术对子宫肌瘤合并高血压患者的影响。方法选取2016年1月—2017年1月唐山市工人医院集团丰南医院收治的子宫肌瘤合并高血压患者70例,采用随机数字表法分为对照组和观察组,每组35例。对照组患者给予米非司酮治疗3个月,观察组患者行HIFU消融术。比较两组患者治疗前及随访12个月后收缩压、舒张压,治疗前及治疗后3、6、12个月子宫肌瘤直径,治疗前及治疗后3个月卵巢功能指标,观察两组患者不良反应/并发症发生情况,并记录观察组患者治疗后24 h内及治疗后3个月子宫内膜损伤情况。结果治疗前两组患者收缩压、舒张压比较,差异无统计学意义(P>0.05);随访12个月后观察组患者收缩压、舒张压低于对照组(P<0.05)。治疗前两组患者子宫肌瘤直径比较,差异无统计学意义(P>0.05);治疗后3、6、12个月观察组患者子宫肌瘤直径短于对照组(P<0.05)。治疗前两组患者雌二醇(E2)、卵泡刺激素(FSH)、促黄体生成素(LH)、泌乳素(PRL)和总睾酮(TSE)比较,差异无统计学意义(P>0.05);治疗后3个月观察组患者E2、FSH、LH高于对照组(P<0.05),而两组患者PRL、TSE比较,差异无统计学意义(P>0.05)。观察组患者不良反应/并发症发生率低于对照组(P<0.05)。治疗后24 h内及治疗后3个月观察组患者无一例出现子宫内膜损伤。结论 HIFU消融术可有效降低子宫肌瘤合并高血压患者血压,缩短子宫肌瘤直径,改善卵巢功能,且安全性较高,对子宫内膜损伤较轻。

Objective To investigate the impact of high-intensity focused ultrasound guided ablation on uterine fibroids patients merged with hypertension.Methods A total of 70 uterine fibroids patients merged with hypertension were selected in the Fengnan Hospital of Tangshan Workers'Hospital Group from January 2016 to January 2017,and they were divided into control group and observation group according to random number,each of 35 cases.Patients in control group received mifepristone for 3 months,while patients in observation group received high-intensity focused ultrasound guided ablation.SBP and DBP before treatment and 12 months after follow-up,diameter of uterine fibroids before treatment,3,6 and 12 months after treatment,index of ovarian function before treatment and 3 months after treatment were compared between the two groups,incidence of adverse reactions/complications in the two groups was observed,incidence of endometrial impairment in observation within 24 hours after treatment and 3 months after treatment was recorded.Results No statistically significant differences of SBP or DBP was found between the two groups before treatment(P>0.05);while SBP and DBP in observation group were statistically significantly lower than those in control group 12 months after follow-up(P<0.05).No statistically significant differences of diameter of uterine fibroids was found between the two groups before treatment(P>0.05),while diameter of uterine fibroids in observation group was statistically significantly shorter than that in control group 3,6 and 12 months after treatment,respectively(P<0.05).No statistically significant differences of E2,FSH,LH,PRL or TSE was found between the two groups before treatment,nor was PRL or TSE 3 months after treatment(P>0.05),while E2,FSH and LH in observation group were statistically significantly higher than those in control group 3 months after treatment(P<0.05).Incidence of adverse reactions/complications in observation group was statistically significantly lower than that in control group(P<0.05).No one in the two groups occurred endometrial impairment within 24 hours after treatment or 3 months after treatment.Conclusion High-intensity focused ultrasound guided ablation can effective reduce the blood pressure in uterine fibroids patients merged with hypertension,shorten the diameter of uterine fibroids,improve the ovarian function,with relatively high safety and mild endometrial impairment.