高强度聚集超声治疗子宫肌瘤疗效观察

摘要

Objective To observe the short-term efficacy and curative effect within 5 years of high-intensity focused ultrasound treat-ment for hysteromyoma.Method Followed up to 5 years for 36 cases of hysteromyoma patients who selected high-intensity focused ultrasound tumor therapy system for the treatment.measured changes in hysteromyoma volume and blood flow regularly.Result All patients completed the treatment.3 months later,the first review found that average volume of hysteromyoma showed no smaller,but hysteromyoma showed less blood supply.6 months after the treatment,the blood supply of myoma scarced,and hysteromyoma average volume shrinked.The total effective rate was 9 1 .7%after 1 year follow-up evaluation.3 years later,blood supply of some myoma increased and re-evaluation the treatment,the to-tal effective rate was 88.9%.4 years after the treatment,the average volume had increased sharply compared with 1 year after the treatment, As the follow-up time extended,the number of patients with increased hysteromyoma volume was gradually increased.To the end of 5 years fol-low-up,the total effective rate was 77.8%.some myoma volume had reached or exceed before treatment,7 patients accompanying with opera-tion indications selected surgical treatment.Conclusion High-intensity focused ultrasound treatment of hysteromyoma had the advantages of non-invasive,safety,and showed a good short-term efficacy;But long-term observation found certain hysteromyoma volume increased,so the long-term efficacy need further clinical test and verify.%目的：观察高强度聚焦超声治疗子宫肌瘤近期以及5年内的疗效。方法对采用高强度聚焦超声肿瘤治疗系统治疗的36例子宫肌瘤患者随访至治疗后5年，定期观察瘤体体积改变和血流变化情况。结果36例患者均完成治疗。治疗后3个月复查发现，子宫肌瘤平均体积未见缩小，但血供明显减少。治疗后6个月肌瘤血供稀少，肌瘤平均体积缩小。1年后随访评估治疗总有效率91．7％，治疗后第3年评估治疗总有效率为88．9％，部分肌瘤可见血供增加；治疗后第4年，子宫肌瘤平均体积与治疗后1年相比，已有明显增大，且随着随访时间的延长，肌瘤增长例数逐渐增多。至第5年随访结束，评估治疗总有效率为77．8％，部分肌瘤已达到或超过治疗前体积，有7例患者因出现手术指征需要行手术治疗。结论高强度聚焦超声治疗子宫肌瘤具有无创性、安全性等优点，近期疗效良好，远期观察可见一定的肌瘤体积增大，故其远期疗效尚需进一步的临床验证。