摘要
Abstract
Objective To evaluate the safety,efficacy of ultrasound-guided high-intensity focused ultrasound in the treatment of uterine fibroids.Methods A retrospective study was conducted in 450 patients with 655 fibroids treated with HIFU and required to complete 2-year follow-up in Suining Central Hospital from December 2010 to June 2014.The follow-up,the parameters of treatment,non-perfusion volume rate (NPVR),adverse reactions and complications were analyzed.Results (1)Treatment data:the mean treatment time was 74 (47 ～ 119)min,the mean irradiation time was 652 (399 ～ 1128)s,and treatment intensity was 557 (454 ～ 652)s/h.The 400 patients,580 fibroids ablation immediately after ultrasound imaging showed NPVR 83％(65％ ～ 100％).Among them,more than 80％ in 325 fibroids,accounting for 56％;greater than 90％ in 230,accounting for 40％;NPVR was 100％ in 146 fibroids,accounting for 25％.(2) Adverse events:adverse events included lower abdominal pain in treatment area (100/450),sacrococcy geal pain (45/450),lower extremity sensory motor function abnormalities (3/450),vaginal bleeding (4/450),vaginal discharge (a small amount of vaginal discharge)(16/450),skin lesion (2/450),nausea and stomach discomfort (6/450),anal bulge (1/450),fever (1/450),urinary retention (1/450),and submucosal fibroids discharged poorly with infection (1/450);all patients had no long-term and serious complications.(3)Volume changes:the volume of leiomyoma before the treatment and 6,12 and 24 months after the treatment was 15.5 (4.7 ～ 52.3)cm3,6.8 (2.3 ～ 21.7)cm3,4.7 (1.5 ～17.1)cm3 and 3.6(0.7 ～ 13.5)cm3,respectively,and the volume of uterine before the treatment and 6,12 and 24 months after the treatment was 165.8 (122.5 ～ 226.2) cm3,144.4 (108.0 ～ 191.2) cm3,137.7 (104.9 ～ 179.1) cm3 and 124.1 (90.5 ～ 167.6)cm3,respectively.Both leiomyoma and uterine volumes decreased significantly after treatments (P ＜ 0.01).(4) UFS-QOL change:the symptom severity score (SSS)before the treatment and 6,12 and 24 months after the treatment was 13 (6 ～ 22),3 (0 ～ 7.5),0 (0 ～ 3),0 (0 ～ 3),which decreased significantly (P ＜ 0.01).The health-related quality of life (HRQL) before the treatment and 6,12 and 24 months after the treatment was 77 (69 ～ 81),87 (80 ～ 91),91(85 ～ 95),93 (86 ～ 97),which increased dramatically (P ＜ 0.01).(5)The rate of secondary surgery:6 patients were treated by myoectomy and hysterectomy within 12 months of follow-up,13 patients chose surgical treatment during the 24-month follow-up,and 2 patients selected secondary HIFU treatment.Conclusion HIFU treatment for some patients with uterine fibroids has good effect.关键词
高强度聚焦超声/子宫肌瘤/远期疗效Key words
high-intensity focused ultrasound/hysteromyoma/long-term efficacy分类
医药卫生
