超声引导下微波消融治疗子宫肌瘤的疗效及安全性分析

目的:评价超声引导下微波消融治疗子宫肌瘤的疗效及安全性,探讨其临床适用性.方法:选择从2007年5月~2011年12月于我院就诊的500例子宫肌瘤患者,简单随机分为微波消融组300例和射频消融组200例.微波消融组患者采用微波消融手术方法治疗,射频消融组患者均选择射频消融手术治疗方法.观察两组患者治疗前后子宫肌瘤体积变化情况.两组患者的治疗疗效和不良反应情况,随访两组患者治疗后3个月的卵巢激素变化情况.结果:两组患者治疗前子宫肌瘤体积比较,差异无显著统计学意义,治疗后均显著降低,差异有统计学意义,且微波消融组和射频消融组患者的子宫肌瘤缩小程度比较,差异无显著统计学意义;微波消融组患者的治疗总有效率为99.33%,射频消融组患者的总治疗有效率为97.50%,两组总有效率比较,差异无统计学意义,随访两组患者的复发率比较,差异也无统计学意义,两组患者手术期间均未出现肠穿孔,膀胱损伤,大出血及急腹症等严重并发症.微波消融组患者的各项不良反应发生率均显著低于射频消融组患者的不良反应发生率,差异有统计学意义,两组患者治疗前卵巢FSH,LH,E2和P比较,差异无显著统计学意义,治疗后各项激素指标比较,差异也无显著统计学意义.结论:微波消融术和射频消融术均可以有效治疗子宫肌瘤,且对卵巢激素无明显影响,且微波消融术治疗子宫肌瘤的不良反应较少,临床应用安全.

The efficacy and safety of Ultrasound - guided microwave ablation in the treatment of uterine myoma

ObjectiveTo analyze the efficacy and safety of Ultrasound - guided microwave ablation in the treatment of uterine myoma.Methods500 cases of patients with uterine myoma were select from May2007 to December2011 in our hos-pital, and they were randomly divided into microwave ablation group of300 cases and radiofrequency ablation group of200 cases. The changes of uterine leiomyoma volume before and after treatment were observed. The therapeutic effect and side ef-fects of the two groups were observed. The changes of ovarian hormones were followed up for3 months after treatment.Results There was no significant difference in the volume of uterine leiomyoma between the two groups before treatment, after treatment, it decreased, and the difference was statistically significant, but that of the microwave ablation group and radiofrequency abla-tion group was no significant difference in the degree of uterine fibroids shrinkage. The total effective rate was99.33% in the microwave ablation group and97.50% in the radiofrequency ablation group, and there was no significant difference. There were no severe complications such as intestinal perforation, bladder injury, hemorrhage and acute abdomen during operation. The incidence of adverse reactions in the microwave ablation group was significantly lower than that in the radiofrequency ablation group, There was no statistically significant difference in FSH, LH, E2 and P between the two groups before treatment. There were no statistically significant differences between the two groups after treatment.Conclusions Microwave ablation and radi-ofrequency ablation can be an effective treatment of uterine fibroids, and no significant effect on ovarian hormones, and micro-wave ablation of uterine fibroids has less adverse reactions, is safety for clinical application.