超声引导经阴道射频消融治疗症状性子宫肌瘤的临床价值

目的:探讨超声引导经阴道射频消融治疗症状性子宫肌瘤的安全性和有效性。方法:选择39例症状性子宫肌瘤患者进行经阴道射频消融治疗。术前超声测量肌瘤体积,采用子宫肌瘤症状和生存质量调查表对患者的子宫肌瘤相关症状的严重程度以及生活质量情况进行评分,观察治疗前和治疗后3、6、9、12个月肌瘤体积缩小率、临床症状及生活质量的改善情况和治疗前后卵巢功能的变化情况。结果:射频消融平均手术时间25分钟,术中及术后均未见明显并发症。本组术前肌瘤体积为65.2±49.3 cm~3;术后3、6、9、12个月肌瘤体积分别为32.2±27.6 cm~3、21.2±18.2 cm~3、15.3±12.1 cm~3、10.3±9.8 cm~3,与术前相比均显著缩小(P0.05)。术前SSS评分为60.23±13.2,术后3、6、9、12个月SSS评分分别为42.2±11.4、21.1±10.2、15.4±10.3、12.2±9.7,与治疗前相比均明显下降(P0.05)。术前QOL评分为58.24±16.24,术后3、6、9、12个月QOL评分分别为70.3±20.3、81.4±8.6、86.3±7.6、88.2±9.1,与治疗前相比逐渐上升,差异有统计学意义(P0.05)。手术后3、6、9、12个月后患者的FSH、LH、E2水平与术前相比,差异均无统计学意义(P0.05)。结论:超声引导下经阴道射频治疗子宫肌瘤可以有效缩小肌瘤体积,改善患者的临床症状,并提高患者的生活质量。

Clincal Value of Ultrasound-guided Transvaginal Radiofrequency Ablation for the Treatment of Symptomatic Uterine Fibroid

ABSTRACT Objective: To investigate the safety and efficacy of ultrasound-guided transvaginal radiofrequency ablation in the treat- ment of symptomatic uterine fibroid. Methods: 39 patients with symptomatic uterine fibroid underwent transvaginal radiofrequency abla- tion therapy were selected Before treatment, the fibroid size and volume were measured using ultrasound. The fibroid-related symptom severity and quality of life were scored using uterine fibroid symptom and quality of life survey. The fibroid volume reduction rate, im- provement in clinical symptom and quality of life, and ovarian function of patients were observed before treatment and at three, six, nine and 12 months after treatment. Results: The average operation time of radiofrequency ablation was 25 minutes. There was no clear intra- and postoperative complication. Preoperative fibroid volume was 65.2±49.3cm³, which was reduced to 32.2±27.6 cm³, 21.2±18.2 cm³, 15.3±12.1 cm³ and 10.3±9.8 cm³ at 3, 6, 9 and 12 months after treatment, respectively(P<0.05). The symptom severity score (SSS) was 60.23±13.2 before treatment, and gradually decreased to 42.2±11.4, 21.1±10.2, 15.4±10.3 and 12.2±9.7 at 3, 6, 9 and 12 months af- ter treatment(P<0.05). The quality of life (QOL) score gradually increased from 58.24±16.24 before treatment to 70.3±20.3, 81.4±8.6, 86.3±7.6 and 88.2±9.1 at 3, 6, 9 and 12 months after treatment(P<0.05). The levels of follicle stimulating hormone, luteinizing hormone and estradiol at 3, 6, 9 and 12 months after treatment showed no difference compared with these before treatment(P>0.05). Conclusion: Ultrasound-guided transvaginal radiofrequency therapy was a minimally invasive, safe, and effective therapy for symptomatic uterine fi- broid.