聚焦超声消融对阔韧带子宫肌瘤的临床疗效

目的分析聚焦超声消融治疗对阔韧带子宫肌瘤患者的临床疗效。 方法选择2018年4月至2019年8月义乌市中心医院收治的48例阔韧带子宫肌瘤患者作为研究对象，按随机数字表法将患者分为栓塞组和消融组各24例。栓塞组采用子宫动脉栓塞术治疗，消融组采用聚焦超声消融治疗。观察2组患者治疗效果、不良反应、肿瘤体积、术后症状缓解时间以及雌激素变化，采用χ²检验比较2组间治疗效果和不良反应的差异，采用t检验比较2组间肌瘤体积、症状缓解时间以及雌激素变化水平的差异。 结果栓塞组、消融组治疗总有效率分别为91.67%、95.83%，2组对比差异无统计学意义（P＞0.05）。栓塞组、消融组不良反应发生率分别为29.17%、25.00%，差异无统计学意义（P＞0.05）。2组患者治疗前肌瘤体积比较，差异无统计学意义（P＞0.05）；治疗后6个月、12个月，消融组肌瘤体积明显小于栓塞组［（22.45±6.78）cm³ vs（32.82±8.63）cm³；（3.25±1.34）cm³ vs（8.26±1.47）cm³］，差异具有统计学意义（t=4.630、12.399，P均=0.001）。消融组压迫症状缓解时间和痛经症状缓解时间均短于栓塞组［（6.42±1.34）d vs（8.92±1.65）d；（10.27±2.13）d vs（13.74±2.58）d］，差异具有统计学意义（t=5.762、5.081，P均=0.001）。治疗前、后2组患者卵泡刺激素和黄体生成素水平比较，差异均无统计学意义（P均＞0.05）。 结论聚焦超声消融治疗阔韧带子宫肌瘤与子宫动脉栓塞术效果相当，且能明显减小肌瘤体积，缩短症状缓解时间。

Clinical efficacy of focused ultrasound ablation for uterine broad ligament leiomyoma

ObjectiveTo evaluate the clinical efficacy of focused ultrasound ablation in patients with uterine broad ligament leiomyoma. MethodsFrom April 2018 to August 2019, 48 patients with uterine broad ligament leiomyoma treated at Yiwu Central Hospital were included as the subjects. Among them, 24 patients were treated by uterine artery embolization and 24 patients by focused ultrasound ablation. The therapeutic effect, adverse reactions, tumor volume, time to postoperative symptom relief, and estrogen changes were recorded. The χ²-test was used to compare differences in the therapeutic effect and adverse reactions between the two groups, and the t-test was used to compare differences in tumor volume, time to postoperative symptom relief, and estrogen changes between the two groups. ResultsThe total effective rate in the embolization and ablation groups was 91.67% and 95.83%, respectively; there was no significant difference between the two groups (P＞0.05). The incidence of adverse reactions also did not differ significantly between the embolization group and ablation group (29.17% vs 25.00%, P＞0.05). Before treatment, there was no significant difference in the volume of leiomyoma between the two groups (P＞0.05); at 6 months and 12 months after treatment, the volume of leiomyoma in the ablation group was significantly smaller than that in the embolization group (22.45±6.78) cm³ vs (32.82±8.63) cm³, t=5.762, P=0.001; (3.25±1.34) cm³ vs (8.26±1.47) cm³, t=5.081, P=0.001]. The time to relief of compression symptom and dysmenorrhea symptom in the ablation group was significantly shorter than that in the embolization group (6.42±1.34) d vs (8.92±1.65) d, t=5.762, P=0.001; (10.27±2.13) d vs (13.74±2.58) d, t=5.081, P=0.001]. There was no significant difference in follicle stimulating hormone and luteinizing hormone levels between the two groups before and after treatment (P＞0.05). ConclusionFocused ultrasound ablation is effective in the treatment of uterine broad ligament leiomyoma, which is comparable to that of uterine artery embolization. Focused ultrasound ablation can obviously reduce the volume of leiomyoma and shorten the time to symptom relief, which is worthy of clinical application and popularization.