超声引导下射频消融治疗子宫肌瘤221例临床分析

目的：探讨射频消融（白凝刀）治疗子宫肌瘤的临床价值。方法：选择从2004年7月-2007年1月自愿接受射频消融治疗子宫肌瘤的患者221例在静脉麻醉及全程超声动态监视和引导下将自凝刀经阴道宫颈置入肌瘤进行射频治疗，其中肌壁间肌瘤138例，黏膜下肌瘤34例，浆膜下肌瘤46例，宫颈肌瘤3例，单发肌瘤178例，多发肌瘤43例，治疗肌瘤总数量338例，瘤体直径0．8～7．0cm。结果：治疗后随访3个月～2年，治疗有效率98．64％（218／221），治愈率：53．39％（108／221），子宫黏膜下肌瘤，浆膜下肌瘤，肌壁间肌瘤以及宫颈肌瘤治愈率分别为79．41％，19．57％，57．97％，66．67％。直径≤3cm肌瘤治愈率（63．56％），3～5cm肌瘤治愈率（71．24％），5～7cm肌瘤治愈率（32．14％）。结论：射频消融治疗子宫肌瘤是一种能保留子宫的微创技术，可重复治疗，疗效确切，操作简单，易推广应用，在子宫肌瘤治疗中对直径3～5cm的肌壁间肌瘤及黏膜下肌瘤的治疗效果最好。

The clinical analysis of radiofrequency treatment under the ultrasonic guides of 221 cases with uterinemyoma

Objective：To approach the clinical value of radiofrequency ablation on the treatment of uterine leiomyoma. Method：221 voluntary patients with uterine myoma from July 2004 to Feb 2007 received radiofrequency ablation under the ultrasonic guide and whole anesthesia, there were 138 intramural myoma, 34 submucosal myoma ,46 serosal myoma, and 3 cervical myoma. 178 cases had single myoma, and 43 cases had more than two myomas. The total quantity of myoma were 338. Result：with following up from 3 month to 2 years, the total effective rate was 98.64% ,the cure rate was 53.38% ,the cure rate of submucosa,serosal,intramural,and cervical myomas were 79.41%. 57%,57.97%,66.67%,respectively. The cure rate of myoma with the diameter of 43 cm,3-5 cm, and 5-7 cm were 63.56%-71. 24%,32.14% ,respectively. Conclusion：The radiofrequency ablation for the uterine myoma is one of the mini--invasive techniques. Intramural and serosal myoma with the size of 3cm-5cm can get the best efficiency.