高强度超声聚焦治疗子宫肌瘤的疗效及安全性分析

Efficacy and safety of high intensity ultrasound focusing on uterine leiomyoma

目的:探讨高强度聚焦超声治疗子宫肌瘤的疗效及安全性,为临床提供科学的理论参考。方法:选取医院收治的50例采用HIFUA治疗的子宫肌瘤患者作为研究对象,其中4例患者不能耐受疼痛中转手术治疗,其余46例患者均行高强度超声聚焦治疗,分析治疗的相关情况,比较治疗前后的子宫肌瘤直径、体积情况,随访观察6个月后皮肤损伤、疼痛、阴道分泌物异常、下肢功能或感觉异常等不良反应情况。结果:46例患者均顺利完成治疗,平均治疗时间(56.39±8.42)min,术后均可下床活动,1周内体能活动恢复正常。患者治疗6个月后的瘤体直径、瘤体体积均小于治疗前,差异有统计学意义(P<0.05)。随访6个月后,患者皮肤损伤发生率为8.70%,疼痛发生率为43.48%,阴道分泌物异常发生率为17.39%,下肢功能或感觉异常发生率为8.70%,术后低热(体温不超过37.8℃)发生率为13.06%。结论:高强度超声聚焦治疗子宫肌瘤疗效确切,不良反应少,安全性高,值得临床广泛推广及应用。

Objective:To analyze the efficacy and safety of high intensity focused ultrasound in the treatment of uterine leiomyoma,To provide scientific theoretical reference for clinical practice.Methods:50 patients with uterine leiomyoma treated with HIFUA were selected as the subjects,Four of them did not tolerate pain,The remaining 46 cases were treated with high intensity ultrasound focusing,Analysis of treatment,To compare the diameter and volume of uterine leiomyoma before and after treatment,follow-up to observe adverse reactions such as skin injury,pain,vaginal discharge abnormalities,lower extremity function or sensory abnormalities after 6 months.Results:46 patients were successfully treated,The average duration of treatment was(56.39±8.42)min,per cent Get out of bed after surgery,Physical activity returned to normal within 1 week.After 6 months of treatment,the diameter and volume of tumor were smaller than before treatment,difference was statistically significant(P<0.05).After six months of follow-up,The incidence of skin damage was 8.70%,The pain rate was 43.48%,The incidence of abnormal vaginal discharge was 17.39%,The incidence of functional or sensory abnormalities was 8.70%,After operation,the incidence of hypothermia(body temperature not exceeding 37.8℃)was 13.06%.Conclusion:High intensity ultrasound focus is effective in the treatment of uterine leiomyoma,less adverse reactions and high safety.It is worth popularizing and applying widely in clinic.