高强度聚焦超声治疗子宫肌瘤与腹腔镜下子宫肌瘤剔除术的比较

目的 对比高强度聚焦超声（HIFU）治疗子宫肌瘤与腹腔镜下子宫肌瘤剔除术（LM）的临床疗效。方法 将我院妇科诊断收治的子宫肌瘤患者64例随机分为观察组和对照组，各32例。观察组应用HIFU对肌瘤进行消融治疗，对照组应用腹腔镜进行肌瘤剔除术治疗。比较两组患者手术时间、住院时间、术中出血量、术后恢复正常生活时间、治疗费用以及术后并发症发生情况；比较两组术后6个月症状改善情况，术后12个月肌瘤复发情况。结果 观察组手术治疗时间（62.48±13.27）min低于对照组的（86.92±15.54）min；住院时间（3.56±0.73）d低于对照组的（6.15±0.87）d；观察组术中无出血，低于对照组出血量（102.76±12.15）ml；术后恢复正常生活时间观察组（4.15±0.76）d，低于对照组的（9.85±1.38）d，差异均有统计学意义（P＜0.05）；观察组治疗费用高于对照组，差异有统计学意义（P＜0.05）；观察组并发症发生4例（12.50%），对照组并发症发生5例（15.62%），差异无统计学意义（P＞0.05）；两组6个月症状改善情况与12个月复发情况比较，差异无统计学意义（P＞0.05）。结论 HIFU消融治疗子宫肌瘤与LM治疗相比，具有安全、无创、治疗时间短、术中出血量少、术后恢复正常生活时间快等优点，临床治愈效果无明显差异，但治疗花费相对较高，临床可根据患者实际情况选择最佳治疗方案。

Comparison of High Intensity Focused Ultrasound in the Treatment of Uterine Fibroids and Laparoscopic Myomectomy

Objective To compare the clinical efficacy of high intensity focused ultrasound (HIFU) in the treatment of uterine fibroids and laparoscopic myomectomy (LM). Methods 64 patients with uterine fibroids admitted to our hospital were randomly divided into observation group and control group, 32 cases each. The observation group was treated with HIFU for ablation of the fibroids, and the control group was treated with laparoscopy for fibroids removal. The operation time, hospitalization time, intraoperative blood loss, postoperative normal life time, treatment cost and postoperative complications were compared between the two groups. The improvement of symptoms was compared between the two groups at 6 months postoperatively, and the recurrence of fibroids was observed 12 months after surgery.Results The operation time of the observation group (62.48±13.27) min was lower than that of the control group (86.92±15.54) min; the hospitalization time (3.56±0.73) d was lower than that of the control group (6.15±0.87) d; the observation group had no bleeding during operation. The amount of bleeding was lower than that of the control group (102.76±12.15) ml; the postoperative normal life time was observed in the observation group (4.15±0.76) d, which was lower than that in the control group (9.85±1.38) d, the difference was statistically significant (P<0.05). The observation group cost was higher than the control group, the difference was statistically significant (P<0.05); the observation group had 4 cases (12.50%) of complications, and the control group had 5 cases (15.62%), the difference was not statistically significant(P>0.05); the 6-month symptom improvement in the two groups was compared with the 12-month recurrence,the difference was not statistically significant (P>0.05).Conclusion Compared with LM treatment, HIFU ablation treatment has the advantages of safe, non-invasive, short treatment time, less intraoperative blood loss, and quicker normal life after surgery. There is no significant difference in clinical cure effect, but the treatment cost is relatively high. Clinically, the best treatment plan can be selected according to the actual situation of the patient.