经阴道超声引导腹腔镜下经皮微波消融治疗子宫腺肌瘤的效果

发布时间：2018-03-13 21:47

本文选题：子宫肿瘤　切入点：腺肌瘤　出处：《中国医学影像学杂志》2017年08期 　论文类型：期刊论文

【摘要】：目的探讨经阴道超声引导腹腔镜下经皮微波消融治疗子宫腺肌瘤的近期疗效及临床应用价值。资料与方法选取2015年10月—2016年10月于武汉市中心医院就诊的痛经程度较重、保守治疗无效但不愿切除子宫的子宫腺肌瘤患者40例,在腹腔镜及阴道超声全程监控和引导下,将微波针置入子宫腺肌瘤体内进行微波消融。结果 40例患者(64个)病灶成功消融,无一例出现损伤周围重要器官、血管等情况,术中出血极少;术后月经量、痛经程度均明显改善,暂未见明显复发;术后1个月、3个月、6个月及1年随访子宫体积分别为(135.0±73.2)cm~3、(108.2±62.9)cm~3、(91.4±58.4)cm~3、(84.8±50.0)cm~3,均小于术前的(207.2±97.4)cm~3,差异有统计学意义(P0.01);术后1个月、3个月、6个月及1年病灶体积分别为(42.3±34.2)cm~3、(30.6±27.4)cm~3、(24.7±23.0)cm~3、(23.0±19.4)cm~3,均小于术前的(67.9±48.2)cm~3,差异有统计学意义(P0.01);实验室检查CA125及CA199与术前相比,差异均有统计学意义(P0.01)。结论微波消融子宫腺肌瘤作为一种保留子宫且解决患者痛苦的微创技术,在腹腔镜的监测下进行,更安全、实时,有望成为治疗子宫腺肌瘤的新途径。
[Abstract]:Objective to investigate the short-term curative effect and clinical application value of transvaginal ultrasound guided percutaneous microwave ablation for uterine adenomyoma. Materials and methods the degree of dysmenorrhea in Wuhan Central Hospital from October 2015 to October 2016 was selected. Forty patients with adenomyoma of the uterus who were not treated with conservative treatment but who did not want to remove the uterus were monitored and guided by laparoscopy and vaginal ultrasound. Results 40 patients (64 lesions) were successfully ablated with microwave needle in adenomyoma of uterus. The degree of dysmenorrhea was improved obviously, but no recurrence was found. At 1 month, 3 months, 6 months and 1 year, the volume of uterus was 135.0 卤73.2 cm ~ (-1). The volume of uterus was 108.2 卤62.9 cm ~ (-1) (91.4 卤58.4) (84.8 卤50.0) cm ~ (3), which was lower than that of preoperative (207.2 卤97.4) cm ~ (3). The difference was significant (P < 0.01), and the volume of lesion was 42.3 卤34.2 ~ 30.6 卤27.4cm ~ 324.7 卤23.0cm ~ 33.0 卤19.4cm ~ (-1), which was lower than that of preoperative (67.9 卤48.4cm ~ (3cm)), 30.6 卤27.4cm ~ (3t) ~ 324.7 卤23.0cm ~ (3), respectively (P = 0.01), and the difference was significant (P < 0.01) after 1 month, 3 months, 6 months and 1 year after operation, the volume of lesion was 42.3 卤34.2cm ~ (30.6 卤27.4) cm ~ (-1), respectively, which was 23.0 卤19.4cm ~ (-1). CA125 and CA199 were compared with those before operation. Conclusion Microwave ablation of uterine adenomyoma, as a minimally invasive technique to preserve the uterus and solve the pain of the patients, is more safe and real-time under the monitoring of laparoscopy, which is expected to be a new approach for the treatment of uterine adenomyoma.
【作者单位】：华中科技大学同济医学院附属武汉市中心医院超声影像科;
【分类号】：R445.1;R737.33

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