目的 探讨超声引导下经皮射频消融治疗黏膜下子宫肌瘤的有效性和安全性。方法 回顾性分析2016-03至2017-11收治的78例有症状的黏膜下子宫肌瘤,计算子宫肌瘤的完全消融率并评价治疗结果,比较术后3个月子宫肌瘤体积、血红蛋白(Hb)定量及子宫肌瘤症状及健康相关生活质量问卷(UFS-QOL)评分。观察和记录治疗过程中及治疗后随访期间患者出现的各种不良反应及并发症。结果 射频消融后3、6、9、12个月病灶体积缩小率分别为65.3%、75.6%、81.5%和91.6%。治疗3个月后,体积减少(35.1±9.7)cm3,血红蛋白增加(31.9±44.05 )g/L,UFS-QOL评分中SSS评分减少(24.7±13.2),HRQL评分增加(17.3±18.65),差异均有统计学意义(P＜0.01)。术后3 d检查未发现严重并发症。结论 超声引导下经皮射频消融治疗黏膜下子宫肌瘤是一种安全有效的治疗方法,适合对子宫保留有需求的患者。
Abstract
Objective To investigate the efficacy and safety of ultrasound-guided percutaneous radiofrequency ablation for submucous uterine fibroids. Methods A retrospective study of 78 patients with symptomatic submucosal uterine fibroids who were treated between March 2016 and November 2017 and met the inclusion criteria was performed to calculate the complete ablation rate of uterine fibroids. The results were compared and the uterus was compared 3 months after ablation,so were fibroid volume, hemoglobin (Hb) quantification, uterine fibroid symptoms and health-related quality of life questionnaire (UFS-QOL) scores. Adverse reactions and complications were recorded during the course of treatment and follow-up.Results The volume reduction rates of lesions at 3, 6, 9, and 12 months after radiofrequency ablation were 65.3%, 75.6%, 81.5%, and 91.6%, respectively. The volume of uterine fibroids, hemoglobin and UFS-QOL scores were significantly decreased at 3 months after treatment (P<0.01). No serious complications were found three days after ablation.Conclusions Ultrasound-guided percutaneous radiofrequency ablation is a safe and effective treatment for submucosal uterine fibroids,which is suitable for patients with uterus retention.
关键词
子宫肌瘤 /
射频消融 /
血红蛋白 /
UFS-QOL评分 /
超声引导
Key words
uterine fibroids /
radiofrequency ablation /
hemoglobin /
UFS-QOL score /
ultrasound-guided
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参考文献
[1] 董 欣, 杨威威, 刘晓艳. 子宫肌瘤不同手术方式对卵巢与性功能的影响[J]. 武警医学, 2017,28(2):145-146.
[2] 袁 珍. 子宫肌瘤患者三种不同术式对卵巢功能的影响[D]. 南昌:南昌大学医学院, 2013.
[3] 胡美丽,王雅慧,杨 欣,等.高强度聚焦超声消融治疗子宫肌瘤疗效观察[J]. 武警医学, 2015, 26(11):1115-1117.
[4] Chen I, Firth B, Hopkins L, et al. Clinical characteristics differentiating uterine sarcoma and fibroids[J]. JSLS,2018,22(1):78-82.
[5] Sohn G S, Cho S, Kim Y M, et al. Current medical treatment of uterine fibroids[J]. Obstet Gynecol Sci, 2018, 61(2): 192-201.
[6] Turtulici G, Orlandi D, Dedone G, et al. Ultrasound-guided transvaginal radiofrequency ablation of uterine fibroids assisted by virtual needle tracking system: a preliminary study[J]. Int J Hyperthermia,2018,11 : 1-8.
[7] Lee B B, Yu S P. Radiofrequency ablation of uterine fibroids: a review[J]. Curr Obstet Gynecol Rep,2016,5(4): 318-324.
[8] Kim C H, Kim S R, Lee H A, et al. Transvaginal ultrasound guided radiofrequency myolysis for uterine myomas[J]. Hum Reprod,2011,26(3): 559-563.
[9] Spies J B, Coyne K, Guaou G N, et al. The UFS-QOL, a new disease-specific symptom and health-related quality of life questionnaire for leiomyomata[J]. Obstet Gyneco,2002, 99(2): 290-300.
[10] Brucker S Y, Hahn M, Kraemer D, et al. Laparoscopic radiofrequency volumetric thermal ablation of fibroids versus laparoscopic myomectomy[J]. Int J Gynaecol Obstet,2014,125(3): 261-265.
[11] Meng X, He G, Zhang J, et al. A comparative study of fibroid ablation rates using radio frequency or high-intensity focused ultrasound[J]. Cardiovasc Intervent Radiol, 2010, 33(4): 794-799.
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