不同声功率聚焦超声治疗各类子宫肌瘤360例疗效观察

目的不同声功率聚焦超声治疗子宫肌瘤的疗效观察。方法将360例子宫肌瘤患者分为甲、乙两组，并采用不同声功率聚焦超声治疗，治疗前及治疗后3个月行彩色多普勒超声（colorDopplerflowimaging，CDFI）观察以比较治疗前后肌瘤大小、质地回声和血流动力学的变化以及患者自觉症状的改善。结果甲组：瘤体缩小30％以上，内部回声明显增强，周围血流信号消失，患者自觉症状明显改善，显效率为55．6％；瘤体缩小〈30％，内部回声增强，周围血流信号减弱或消失，患者自觉症状缓解，有效率为36．9％。乙组：瘤体缩小30％以上，内部回声增强，周同血流信号消失，患者自觉症状明显改善，显效率为64．0％；瘤体缩小〈30％，内部回声增强，周围血流信号减弱或消失，患者自觉症状缓解。有效率为33．5％。结论聚焦超声治疗子宫肌瘤在临床中是一种无创伤、无痛苦、疗效可靠的方法；在一定范围内，采用声功率高、间歇时间短、单点次数多的治疗方案效果更好；肌壁间肌瘤的疗效明显优于黏膜下肌瘤和浆膜下肌瘤的疗效。

Observation of curative effect on different acoustical power focused ultrasound treatments for 360 patients with hysteromyoma

Objective To evaluate the clinical effect of different acoustical power focused ultrasound treatment for hysteromyoma.Methods 360 patients with hysteromyoma were divided into two groups and treated with different acoustical power focused ultrasound.Before treatment and three months later,the color Doppler flow imaging(CDFI) was used to evaluate the changes at the size,echo and hemodynamic of tumors and patients′ improving.Results Group A:The tumor shrank in size by more than 30%,ultrasonic echo of tumor was enhanced obviously,the around bloodstream was disappeared,patients felt improved excellently,excellent result was achieved in 55.6%.The tumor shrank in size by less than 30%,ultrasonic echo of tumor was enhanced,the around bloodstream was weaken or disappeared,patients felt improved,good result was achieved in 36.9%.Group B: the tumor shrank in size by more than 30%,ultrasonic echo of tumor was enhanced,the around bloodstream was disappeared,patients felt improved excellently,excellent result was achieved in 64.0%.The tumor shrank in size by less than 30%,ultrasonic echo of tumor was enhanced,the around bloodstream was weaken or disappeared,patients felt improved,good result was achieved in 33.5%.Conclusion It was concluded that focused ultrasound is an effective,less painful and non-invasive way to treat hysteromyoma.In a certain range,using a high acoustical power,short-time interval,single-point shot frequently treatment plan will get better response;it is obviously better for intramuralmyoma than for subserousmyoma or submucousmyoma.