高强度聚焦超声治疗子宫肌瘤临床研究

目的探讨高强度聚焦超声(high intensity focused ultrasound,HIFU)治疗子宫肌瘤的近期疗效及安全性。方法选择2005年5月至2010年12月诊断为子宫肌瘤、不愿意手术、要求保留子宫、已生育的956例作为治疗对象,共有子宫肌瘤1116个,按瘤体大小分A、B、C三组。采用HIFU治疗,比较治疗前与治疗后3个月症状、瘤体大小及瘤体内超声影像学变化。结果治疗总有效率:A组100%、B组97.9%、C组67.4%。3个月后肌瘤体积缩小率:A组66.44%、B组57.05%、C组5.71%。月经不调缓解率85.8%,腰骶坠胀缓解率83.1%,尿频缓解率72.3%。并发症:治疗后5例持续阴道流血,11例皮肤I度烫伤,2例浅II度烫伤,1例深II度烫伤,14例肉眼血尿,28例下腹部腰骶部疼痛。结论HIFU治疗子宫肌瘤比较安全、有效,可作为一种无创性治疗子宫肌瘤的方法。

Clinical study of high intensity focused ultrasound in treatment of hysteromyoma

Objective To investigate short-term therapeutic effect and safety of high intensity focused ultrasound （HIFU） in treatment of hysteromyoma. Methods From May 2005 to December 2010,956 procrea- ted women diagnosed as hysteromyoma, unwilling to accept operation and wanting to keep their uteri, were selet- ed as therapeutic cases. The number of myomas was 1116 ,and the patients were divided into group A ,B, and C according as the size of myomas. Treatment was carried out by HIFU. The clinical symptoms, dimension of myo- mas and uhrasonographic changes inside myomas before and 3 months after the treatment of HIFU were com- pared. Results The total effective rate of 956 hysteromyoma patients treated with HIFU were 100% ,97.9%, and 67.4% in Group A,B,and C. The rate of reducing of dimensions of myomas three month later were 66. 44% ,57.05% ,and 5.71%. The remitting rate of menoxenia was 85.8% , and that of lumbosacral hypostatic distending pain was 83.1% and that of frequency of micturation was 72. 3%. After HIFU ablation, unremitting vagina bleeding occurred in 5 cases, Ⅰ°skin scalding occurred in 11 cases and superficious Ⅱ°skin scalding oc- curred in 2 cases and deep Ⅱ°skin scalding occurred in 1 case ,gross hematuria occurred in 14 cases ,and lower abdominal and lumbosaeral pain occurred in 28 cases. Conclusion In the treatment of hysteromyoma,HIFU is safe and effective and is a noninvasive therapeutic method.