中国冶金工业医学杂志

高强度聚焦超声在子宫腺肌症治疗中的临床价值

作者：王丽萍柳弘彦雷玉珍

分类号：R 445

出版年,卷(期):页码：2018,35(1):4-5

摘要：

摘要：目的探讨高强度聚焦超声（HIFU）在子宫腺肌症治疗中的价值。方法利用JC型聚焦超声肿瘤治疗系统对50例临床诊断明确的子宫腺肌症患者进行治疗，治疗后1、3个月使用盆腔增强核磁共振成像（MRI）对患者临床症状、病灶的大小及血供情况进行前后对比观察，评估治疗效果。结果治疗后1、3个月与治疗前相比，月经量增多患者症状缓解，有效率分别为56％（28/50）、76％（38/50）；痛经症状缓解有效率分别为72％（36/50）、80％（40/50）；治疗后1、3个月子宫腺肌症病灶消融后血供减少形成凝固性坏死，腺肌症病灶及子宫体积均较治疗前明显缩小，差异有统计学意义（P＜005）。腺肌症病灶凝固性坏死率为65％~96％，平均76％；其中凝固性坏死率90％以上的有13例，临床症状缓解显著有效；凝固性坏死率78％以上35例，临床症状缓解有效；凝固性坏死率＜20％有2例，治疗后临床症状无好转。50例患者均无严重并发症发生。结论HIFU在治疗子宫腺肌症中的疗效取决于异位病灶区消融范围的大小；HIFU是一种可保留子宫且安全、有效治疗子宫腺肌症的方法。关键词：高强度聚焦超声；子宫腺肌症；安全；有效

Abstract：ObjectiveTo explore the value of high intensity focused ultrasound（HIFU）in the treatment of adenomyosis MethodsFifty patients diagnosed definitely with adenomyosis were treated with JC\|mode Focused Ultrasound Therapy System Pelvic enhanced MRI examination was performed one month，three months after HIFU treatment respectively The patients' clinical symptoms，lesion size and blood supply was contracted before and after HIFU treatment，then therapy effect was evaluated ResultsOne month，3 months after treatment，the remission rate of increased menstruation was 56%（28 cases），76%（38 cases），the remission rate of dysmenorrhea symptoms was 72%（36 cases），80%（40 cases） Pelvic enhanced MRI examination after 1 month，3 months showed blood supply decreased in the ablated lesions，which obviously shrank，and uterus also became smaller The difference was significant（P＜005） The lesion necrosis rate was 65%~96%，an average was 76%，the lesion with its necrosis rate more than 90% in 13 cases，necrosis rate more than 78% in 35 cases，necrosis rate less than 20% in 2 cases and no improvement of clinical symptoms No serious complications occurred in all 50 patients ConclusionThe effect of HIFU treatment of adenomyosis depends on the ablation extent of the ectopic lesion，and HIFU is a safe and effective method for treating adenomyosis with uterus preservedKey Words:High Intensity Focused Ultrasound；Adenomyosis；Safe；Effectiveness

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参考文献：

参考文献\[1\]张信美，石一复．子宫腺肌症患者子宫次全切术后的危险性探讨\[J\]现代妇产科进展，2001，10（2）：120\|122．

\[2\]Vaezy S，Shi X，Martin RW，et al Real time visualization of high\| intensity focused ultrasound imaging \[J\]Ultrasound Med Biol，2001，27（1）：33\|42

\[3\]汪伟，刘文英，周洁敏，等高强度聚焦超声治疗症状性子宫肌瘤的初步研究\[J\]中华超声影像学杂志，2002，11（3）：161\|163

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