高强度聚焦超声治疗子宫腺肌病效果评价

目的评价高强度聚焦超声(HIFU)治疗子宫腺肌病的疗效、不良反应及对患者生活质量的影响。方法采用HIFU治疗84例子宫腺肌病患者,通过增强磁共振成像(MRI)评价消融的情况;记录治疗后各种不良事件;治疗前及术后1、3、6个月分别应用SF-36健康调查量表评估健康相关生活质量。结果治疗后患者痛经症状得到不同程度改善,总有效率为95.2%;术后1、3、6个月痛经评分与治疗前相比均降低,差异有统计学意义(P<0.01)。术后增强MRI显示子宫腺肌病病灶消融率为(73.2±17.5)%。治疗后所有不良反应均未超过国际介入放射治疗协会标准不良反应分级B级。术后1、3及6个月患者SF-36健康调查量表维度中生理功能、社会功能、生理职能、躯体疼痛、精力及情感职能均较治疗前明显改善(P<0.01)。结论 HIFU作为子宫腺肌病保守治疗的一种新方法,能有效消融子宫腺肌病病灶,迅速缓解临床症状,不良反应小,患者生活质量改善明显。

Efficacy evaluation for adenomyosis after high intensity focused ultrasound treatment

Objective To evaluate the efficacy,adverse events and influence for life quality of high intensity focused ultrasound（ HIFU） for the treatment of adenomyosis. Methods Eighty-four female patients with adenomyosis were treated with the HIFU. The efficacy of ablation was evaluated by enhanced magnetic resonance imaging（ MRI）. The adverse event after treatment were recorded. Health-relatedquality of life of the patients were evaluated at 1 month,3 and 6 months after treatment using the MOS 36-item short form health survey（ SF-36） health survey questionnaire. Results The dysmenorrhea symptom was improved in 80 patients and the total effective rate was 95. 2%. The dysmenorrhea scores were decreased significantly 1 month,3 and 6 months after operation compared with that before operation（ P〈0.01）. The ablation ratio of adenomyosis lesion detected by the enhanced MRI was（ 73. 2 ± 17. 5） % after treatment. All side effects after treatment were under the B-level of the standard classification of Society of Interventional Radiology. Regarding SF-36 subscale scores,at 1 month,3 and 6 months there was improvement in physical functioning,social functioning,role physical,bodily pain,vitality,and role emotional subscales（ P〈0.01）. Conclusion HIFU treatment on adenomyosis can ablation the focus,release the clinical symptoms and improve the life quality quickly with few adverse events as a new expectant treatment.