高强度聚焦超声治疗子宫肌瘤300例的临床疗效分析

目的：探讨高强度聚焦超声（high intensity focused ultrasound,HIFU）治疗子宫肌瘤的临床疗效及其安全性。方法：回顾性分析我院2007年1月～2011年1月300例采用高强度聚焦超声治疗的子宫肌瘤患者的临床资料,比较分析治疗前后瘤体大小、病灶内部回声、临床症状改善情况、血流的变化及超声造影图像改变。结果：HIFU治疗后1、3、6及12个月,瘤体体积均较治疗前显著缩小（P〈0.05）,显效率80.33%（241例）,有效率19.33%（58例）,无效率0.33%（1例）,肌瘤所致的临床症状减轻或消失,瘤体内部回声增强,彩色血流均消失,超声造影瘤体内无灌注。治疗期间,患者出现治疗部位疼痛、骶尾部酸胀及肛门坠胀,治疗结束时症状消失;治疗过程中出现腿部疼痛、麻木症状,经过重新定位后症状消失,少数出现阴道少量流血,给予止血药;治疗后出现血尿,经大量喝水排尿后消失。结论：HIFU治疗子宫肌瘤是安全有效的,在妇科领域便于推广。

Analysis of the Clinical Efficacy of High Intensity Focused Ultrasound in the Treatment of 300 Cases of Uterine Fibroids

Objective： To explore the clinical efficacy and security 0fHIFU in the treatment of uterine fibroids. Methods： The clinical data of 300 patients with uterine fibroids who were treated by high-intensity focused ultrasound in our hospital were analyzed retrospectively from January 2007 to January 2011, in which the tumor size, lesion internal echo, improvement of clinical symptoms before and after treatment, changes in blood flow and ultrasound contrast image change were analyzed comparatively. Results： Compared with pre-treatment, the tumor volumes 1, 3, 6 and 12 months after treatment by HIFU were significantly reduced（P〈0.05）, the significant efficiency was 80.33% （241 cases）, effective rate was 19.33% （58 cases） and inefficiency was 0.33% （1 case）. The clinical symptoms that caused by the Fibroids were relieved or disappeared; the internal echo was enhanced and the color flow disappeared in the tumor; there was no perfusion in the tumor in ultrasound contrast. During treatment, some patients may feel pain, sacrococcygeal soreness and anal bulge which disappeared after treatment. Some patients feeled leg pain, numbness that disappeared after repositioning;few who were given hemostatic appeared a small amount of vaginal bleeding;and some patients had hematuria which disappeared after drinking a large number of water. Conclusion： HIFU was safe and effective in the treatment of uterine fibroids, which was easy to be popularized in the field of gynecology.