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高强度聚焦超声治疗再发性子宫腺肌病的疗效观察

Efficacy of high-intensity focused ultrasound ablation in the treatment of patients with recurrent adenomyosis
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摘要 目的应用高强度聚焦超声(HIFU)治疗再发性子宫腺肌病(AM),并观察其疗效。方法前瞻性选取于我院行HIFU消融治疗的再发性AM患者92例,应用超声造影观察病灶消融情况,计算即刻平均消融率。于消融治疗后3、6、12、18、24个月随访有无再发、痛经情况、子宫体积及是否妊娠。结果92例再发性AM患者HIFU消融治疗后即刻平均消融率为(76.67±6.22)%,且治疗期间均未见消融相关并发症。消融治疗后3、6、12、18、24个月痛经缓解率分别为88.04%、75.00%、55.43%、42.86%、32.97%;消融治疗后3、6、12、18、24个月痛经治疗有效的患者分别为81、69、51、40、31例,对应的子宫体积分别为(161.78±75.03)cm^(3)、(168.50±84.77)cm^(3)、(177.44±94.89)cm^(3)、(177.73±84.02)cm^(3)、(188.89±90.47)cm^(3)。随访期间发现有6例患者妊娠。消融治疗后6、12、18、24个月痛经再发率分别为13.18%、32.61%、45.05%、54.35%。结论HIFU治疗再发性AM安全、有效,尽管其长期复发率较高,但仍可作为年轻且希望保留子宫患者的一种治疗选择。 Objective To explore the efficacy of high-intensity focused ultrasound(HIFU)ablation in the treatment of patients with recurrent adenomyosis(AM).Methods Ninety-two patients with recurrent AM who underwent HIFU ablation in our hospital were prospectively selected.Contrast-enhanced ultrasound was used to observe the ablation condition,and the average ablation rate immediately after HIFU ablation was calculated.Follow-ups were performed at 3,6,12,18 and 24 months post-ablation to assess recurrence,dysmenorrhea,uterine size and pregnancy status.Results The average ablation rate of 92 patiens with recurrent AM was(76.67±6.22)% immediately after HIFU ablation,and no ablation-related complications occurred.The dysmenorrhea relief rates at 3,6,12,18 and 24 months after ablation were 88.04%,75.00%,55.43%,42.86% and 32.97%,respectively.The number of effective patients at 3,6,12,18 and 24 months after ablation were 81,69,51,40 and 31 cases,and the average uterine volumes were(161.78±75.03)cm^(3),(168.50±84.77)cm^(3),(177.44±94.89)cm^(3),(177.73±84.02)cm^(3) and(188.89±90.47)cm^(3),respectively.During the follow-up period,6 patients were found to be pregnant.The recurrent rates at 6,12,18 and 24 months after ablation were 13.18%,32.61%,45.05% and 54.35%,respectively.Conclusion HIFU ablation is safe and effective for patients with recurrent adenomyosis.Although the long-term recurrence rate is relatively high,it remains a viable treatment option for young patients who wish to preserve their uterus.
作者 许莉莉 黄静 黄凤叶 张静 杨柳 XU Lili;HUANG Jing;HUANG Fengye;ZHANG Jing;YANG Liu(Department of Gynecology,the People’s Hospital of Guangxi Zhuang Autonomous Region,Guangxi Academy of Medical Sciences,Nanning 530016,China)
出处 《临床超声医学杂志》 CSCD 2024年第8期647-650,共4页 Journal of Clinical Ultrasound in Medicine
基金 广西医疗卫生适宜技术开发与推广应用项目(S2020082)。
关键词 高强度聚焦超声 子宫腺肌病 痛经 再发 High-intensity focused ultrasound Adenomyosis Dysmenorrhea Recurrence
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