射频消融治疗子宫肌瘤术后取瘤临床研究

【目的】探讨超声引导下射频消融治疗子宫肌壁间肌瘤术后取瘤的可行性、安全性及适宜时间。【方法】对2008年1月-2011年12月40例在本院门诊行射频消融治疗子宫肌瘤患者术后在超声引导下用负压吸引吸出瘤核内的变性坏死组织,并设对照组,对取瘤组的取瘤时机、时间的选择、对两组患者取瘤后的阴道排液流血、腹痛情况进行回顾性分析。【结果】取瘤组于射频消融治疗子宫肌瘤术后第26~66天时机成熟行取瘤术,手术顺利取出变性坏死组织,无1例子宫穿孔或大出血发生。取瘤组和对照组的阴道排液、腹痛情况比较有显著性差异(P<0.05,P<0.01)。【结论】超声引导下射频消融治疗子宫肌瘤,是一种能够保留子宫的安全有效简单的治疗手段,术后适宜时间取瘤是安全可行的,能减轻射频消融治疗后的并发症,提高患者对射频消融治疗方法的心理接受能力。最佳取瘤时间为射频消融治疗后1~2个月。

Clinical study of hysteromyoma removement after radiofrequency ablation

【Objective】To explore the feasibility,safety and suitable timing of hysteromyoma removement after radiofrequency ablation（RFA） under ultrasonic guidance.【Methods】80 patients after RFA from 2008 to 2011（40 cases received the operation of hysteromyoma removement;40 patients were considered as the control group） were observed.Necrostic hysteromyoma was removed under color Doppler imaging.The timing,vaginal apocenosis,stomachache were retrospectively analyzed between the two groups.【Results】The days from 26th to 66th after RFA was the best timing for hysteromyoma removement.There was no perforation or hemorrhoea,and there were marked differences in vaginal apocenosis and stomachache between the experimental group and the control one（P 0.05,P 0.01）.【Conclusions】The treatment of hysteromyoma after RFA under ultrasonic guidance was safe,simple and effective to preserve uterine.The best timing of hysteromyoma removement was the 1st or second month after RFA,which could lighten the complications and improve the patients＇ mental receptivity.