摘要
目的探讨高强度聚焦超声(high intensity focused ultrasound,HIFU)治疗子宫肌瘤患者的妊娠结局指标及新生儿相关指标。方法将2017年6月至2019年6月,在遂宁市中心医院因单发子宫肌瘤行HIFU治疗的患者根据纳入排除标准筛查出HIFU组(80例),并选取同期因子宫肌瘤就诊但未行任何治疗的有生育愿望的子宫肌瘤患者为带瘤组(80例)。随访月经量、生育史、体重指数、子宫体积、消融时间、消融功率、靶肌瘤消融率、缩小率、妊娠相关情况及有无妊娠期并发症。结果HIFU组妊娠48例,术后妊娠率及分娩率均高于带瘤组。HIFU组平均受孕时间短于带瘤组,且受孕时间窗提前,集中在术后7~18个月(P<0.05)。HIFU组产后出血量明显低于带瘤组(P<0.05)。两组在妊娠期高血压疾病、肝内胆汁淤积症、妊娠期糖尿病、胎膜早破、早产、头盆不称及前置胎盘的发生率差异无统计学意义(P>0.05)。两组终止分娩的方式无明显差异,均未发现胎儿窘迫、胎盘早剥及子宫破裂。HIFU平均治疗总能量低于321894 J,平均消融时间小于733 s的患者妊娠率更高。结论HIFU治疗可缩短有生育意愿子宫肌瘤患者的备孕周期,降低子宫肌瘤孕妇产后出血发生率。不导致子宫破裂、胎儿窘迫、胎盘早剥等严重并发症。HIFU治疗能量可能与术后妊娠率有关。
Objective To analyze the pregnancy and neonate-related outcomes of patients with uterine fibroids treated by HIFU(high-intensity focused ultrasound).Methods Eighty patients with a single uterine fibroid treated by HIFU from June 2017 to June 2019 in our hospital were selected as the HIFU group according to the inclusion and exclusion criteria.Another 80 patients with uterine fibroids receiving no treatment were selected as the tumor-bearing group(control group),who had fertility desire.Menstrual volume,gestational history,BMI,uterine volume,ablation time,ablation power,target myoma ablation rate,reduction rate and pregnancy-related indicators and complications were followed up.Results There were 48 cases in HIFU group who conceived.The pregnancy rate and delivery rate of HIFU group were higher than those of the control group.The average pregnancy time of HIFU group was shorter than that of control group,and the time window of conception was advanced in HIFU group,concentrating in 7-18 months after operation(P<0.05).The postpartum hemorrhage in HIFU group was significantly less than that in control group.There was no statistical difference in the incidence of hypertensive disorder complicating pregnancy,intrahepatic cholestasis of pregnancy,gestational diabetes mellitus,premature rupture of membranes,premature delivery,cephalopelvic disproportion or placenta previa between the two groups(P>0.05).There was no obvious difference in delivery mode between the two groups.There was no fetal distress,placental abruption or uterine rupture in both groups.The patients with lower mean total treatment energy of HIFU(less than 321894J)and shorter mean sonication time(less than 733seconds)had higher pregnancy rate.Conclusions HIFU treatment can shorten the pregnancy preparation period of patients with uterine fibroids who are willing to give birth and reduce the incidence of postpartum hemorrhage in pregnant women with uterine fibroids.There are no severe complications such as uterine rupture,fetal intrauterine distress or pla
作者
刘晓芳
罗爽
林芳
黄国华
牟燕
何佳
胡丽娜
LIU Xiao-fang;LUO Shuang;LIN Fang;HUANG Guo-hua;MU Yan;HE Jia;HU Li-na(Department of Gynecology and Obstetrics,Suining Central Hospital,Suining 629000,China;不详)
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2023年第2期213-217,共5页
Chinese Journal of Practical Gynecology and Obstetrics
基金
四川省卫生健康委员会科研课题(20PJ283)。
关键词
子宫肌瘤
高强度聚焦超声
妊娠并发症
妊娠结局
uterine fibroids
high intensity focused ultrosound(HIFU)
pregnancy complication
pregnancy outcome
