Clinical observation of high intensity focused ultrasound in the treatment of adenomyosis of uterus
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摘要:
目的探初步观察高强度聚焦超声治疗子宫腺肌症的疗效。 方法对我院采用高强度聚焦超声消融治疗的25例子宫腺肌症患者进行定期症状随访,随访痛经及月经改善情况。 结果25例患者均完成治疗,随访至6个月,痛经缓解率86%,月经减少率84%,近期疗效显著。 结论高强度聚焦超声消融治疗是一种保留子宫的无创治疗技术,能够有效治疗子宫腺肌症病灶,缓解痛经、月经量多等症状,近期效果确切,远期疗效尚需进一步临床观察验证。 Abstract:Objective To observe the effect of high intensity focused ultrasound in the treatment of adenomyosis of uterus. Methods A total of 25 cases of patients with adenomyosis of uterus disease were treated with high intensity focused ultrasound ablation, and were followed up regularly,records of dysmenorrhea and menstrual conditions. Results A total of 25 patients completed the treatment and were followed up for 6 months, the remission rate of dysmenorrheal was 86%, menstrual volume reduction rate was 84%,recent curative effect was obvious. Conclusion High intensity focused ultrasound ablation is a noninvasive technique to preserve the uterus, recent curative effect is obvious, the long-term effect ie still need to be further clinical observation and verification. -
表 1 25例子宫腺肌症患者一般资料
项目 结果 年龄(岁) 40.4±6.1 孕产史(次) 3.1±1.4 术前治疗(例) 药物 6 上环(曼月乐) 4 病灶部位(例) 有前壁症状 10 有后壁症状 13 前后壁均有 2 症状(例) 经量多、经期延长 19 痛经 22 贫血 5 病灶体积(mm3) 50.3±14.7 表 2 患者治疗前及治疗后经量多、痛经例数对比分析(例)
治疗前 治疗后1个月 治疗后3个月 治疗后6个月 经量多 19 13 9 3 痛经 22 8 8 3 -
[1] 李宗涛, 张炜旸, 芳华, 等. 子宫腺肌病的最新治疗进展[J]. 中国妇幼保健, 2014, 29(27): 4524-6. http://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201427063.htm [2] 王智彪. 聚焦超声治疗技术在妇科领域的研究与应用[J]. 中华妇产科杂志, 2006, 41(9): 638-40. http://www.cnki.com.cn/Article/CJFDTOTAL-ZHFC200609029.htm [3] Zhang L, Chen WZ, Liu YJ, et al. Feasibility of magnetic resonance imaging-guided high intensity focused ultrasound therapy for ablating uterine fibroids in patients with bowel lies anterior to uterus [J]. Eur J Radiol, 2010, 73(2): 396-403. doi: 10.1016/j.ejrad.2008.11.002 [4] Orsini L, Salardi S, Pilu G, et al. Cacciari E.pelvic organs in premenarcheal girls:real-time ultrasonography[J]. Radiology, 1984, 153(2): 113-6. doi: 10.1148/radiology.153.1.6473771 [5] Huang BS, Seow KM, Tsui KH, et al. Fertility outcome of infertile women with adenomyosis treated with the combination of a conservative microsurgical technique and GnRH agonist: Long-term follow-up in a series of nine patients[J]. Taiwan J Obstet Gynecol, 2012, 51(2): 212-6. doi: 10.1016/j.tjog.2012.04.008 [6] 王世阆. 子宫腺肌病诊治问题的思考[J]. 国际妇产科学杂志, 2008, 35 (2): 80-1, 91. http://www.cnki.com.cn/Article/CJFDTOTAL-GWVC200802003.htm [7] 关铮, 张卓梅, 宫庭钰, 等. 子宫神经去除术治疗子宫腺肌症疼痛的临床观察[J]. 中国妇产科临床杂志, 2008, 9(2): 103-5. http://www.cnki.com.cn/Article/CJFDTOTAL-FKLC200802009.htm [8] Quemere MP, Cravello L, Roger V, et al. Impact of adenomyosis on results of endometrial ablations[J]. Contracept Fertil Sex, 1999, 27 (5): 357-63. http://cn.bing.com/academic/profile?id=7575536&encoded=0&v=paper_preview&mkt=zh-cn [9] Osada H, Silber S, Kakinuma T, et al. Surgical procedure to conserve the uterus for future pregnancy in patients suffering from massive adenomyosis[J]. Reprod Biomed Online, 2011, 22(1): 94-9. doi: 10.1016/j.rbmo.2010.09.014 [10] 徐惠成, 梁志清, 陈勇, 等. 腹腔镜下子宫动脉阻断术治疗子宫腺肌病的疗效分析[J]. 第三军医大学学报, 2004, 26(22): 2009-11. http://www.cnki.com.cn/Article/CJFDTOTAL-DSDX200422012.htm [11] 冷金花, 郎景和. 子宫腺肌病的手术治疗[J]. 实用妇产科杂志, 2006, 22(1): 10-2. [12] Wu F, Wang ZB, Chen WZ, et al. Extracorporeal focused ultrasound surgery for treatment of human solid carcinomas: early Chinese clinical experience[J]. Ultrasound Med Biol, 2004, 30(2): 245-60. doi: 10.1016/j.ultrasmedbio.2003.10.010 [13] 王捍平, 蔡丽萍, 冯萍娟, 等. 高强度聚焦超声治疗子宫腺肌症的疗效观察[J]. 检验医学与临床, 2008, 5(16): 976-7. http://www.cnki.com.cn/Article/CJFDTOTAL-JYYL200816010.htm [14] 吴莺, 高悦, 王燕, 等. 高强度聚焦超声单次整体治疗子宫腺肌症的临床研究[J]. 中国超声医学杂志, 2013, 29(10): 918-22. http://www.cnki.com.cn/Article/CJFDTOTAL-ZGCY201310016.htm [15] 王丽萍, 翁亚娟, 王亚金. 高强度聚焦超声在子宫腺肌症治疗中的价值[J]. 陕西医学杂志, 2012, 41(10): 1318-9. http://www.cnki.com.cn/Article/CJFDTOTAL-SXYZ201210021.htm
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