高强度聚焦超声治疗97例子宫肌瘤的疗效探讨

目的：探讨高强度聚焦超声（HIFU）治疗子宫肌瘤的安全性及有效性。方法：2008年8月-2010年10月在章丘市中医院经彩色多普勒超声检查确诊为子宫肌瘤的已婚患者97例，对其进行高强度聚焦超声治疗，治疗前均行彩色多普勒超声检查以确定肌瘤个数、大小、部位、形态、回声特征、血流分布情况，于术后3个月、半年、1年随访观察，对比治疗前、后患者的临床症状及声像图变化，评价疗效。结果：97例子宫肌瘤患者HIFU治疗后49例瘤体不同程度缩小，边缘呈环形增强，部分边缘模糊，内部回声增强明显，瘤体内血流信号消失，临床症状明显改善；41例瘤体轻度缩小或无缩小，边缘回声无改变或稍增强，内部回声稍增强或强弱不均，瘤体内部血流信号减少，临床症状部分改善；7例瘤体增大，内部回声强弱不均，瘤体周边及内部血供丰富。HIFU治疗子宫肌瘤的有效率为92．78％（其中显效49例，占50．51％；有效41例，占42．27％），无效7例占7．22％。结论：瘤体体积缩小、血流信号消失和临床症状改善是衡量高强度聚焦超声治疗子宫肌瘤疗效的可靠指标。高强度聚焦超声治疗子宫肌瘤疗效确切，安全性高，可重复多次治疗，是保全子宫的无痛无创治疗新技术。

Evaluation of Efficacy of High Intensity Focused Ultrasound in the Treatment of 97 Cases Uterine Myoma

Objective：To evaluate the efficacy and safety of high intensity focused uhrasound （HIFU） in the treatment of uterine leiomyomas. Method：Between august 2008 and December 2010, A total of 97 children-born-aged women with uterine leiomyomas were chosed for the therapy with HIFU. Before the treatment, color Doppler ultrasound were performed to determine the number, size, boundary, shape, interior echo type, rear echo characteristics and flow features of the uterine leiomyomas.The clinical symptoms and uhrasonographic changes were observed periodically, and the efficacy of HIFU was evaluated at three months, six months and twelve months after treatment.Result：At 3, 6, and 12-months follow-up, 49 cases were found relief of symptoms, and the uterine leiomyomas size shrank in varying degrees and showed cricoid strengthening on the edge.The hysteromyoma eehogenteity increased evidently and the tumor feeding vessels disappeared gradually.In 41 cases, the clinical symptom were partly improved, and the uterine leiomyomas size shrank slightly or barely changed.The hysteromyoma echogenicity increased slightly and the tumor feeding vessels reduced. in 7 cases, the uterine leiomyomas size increased.The hysteromyoma echogenlcity was uneven and the tumor feeding vessels were rich.Among 97 cases, 49cases （50.51%） achieved significant curative effect;41 cases （42.27%）, moderated curative effect; and 7cases （7.22%） failed to respond to the treatment. Conclusion：Treatment of uterine leiomyomas with HIFU is safe, repeatable and significantly effective, and HIFU appears to be a new non-invasive and painless method for the treatment of uterine leiomyomas.