子宫肌瘤超声消融术后妊娠对靶肌瘤的影响及妊娠结局

发布时间：2018-03-04 13:47

本文选题：子宫肿瘤　切入点：肌瘤　出处：《中国介入影像与治疗学》2017年05期 　论文类型：期刊论文

【摘要】：目的探讨子宫肌瘤行高强度聚焦超声(HIFU)消融治疗后妊娠者孕产期靶肌瘤的转归情况及妊娠结局。方法选择在我院接受HIFU治疗后妊娠者123例,收集临床资料、肌瘤的影像学特征信息,进行孕产期靶肌瘤相关情况随访。结果术后中位随访时间为3年,与妊娠前比较,60例(60/123,48.78%)患者孕早中期靶肌瘤增大,平均增大直径(2.1±1.6)cm;22例剖宫产+剔除靶肌瘤患者中,与孕前、孕早中期相比,分别有3例(3/22,13.63%)、13例(13/22,59.09%)发生缩小;产后3个月B超复查的27例患者中,靶肌瘤与孕前、孕早中期相比,分别有12例(12/27,44.44%)、18例(18/27,66.67%)靶肌瘤缩小。123例HIFU术后妊娠者中,成功分娩84例、正在妊娠18例、人工流产4例,自然流产17例,成功分娩和自然流产患者术前妊娠丢失史、年龄、肌瘤数量、孕期肌瘤增大发生率差异有统计学意义(P均0.05),孕期靶肌瘤增大值差异无统计学意义(P0.05)。结论子宫肌瘤超声消融后妊娠,部分靶肌瘤在孕早中期呈暂时增大,但仍小于HIFU术前靶肌瘤最大径;妊娠晚期靶肌瘤较妊娠早中期无明显变化,产后靶肌瘤呈逐渐缩小趋势。HIFU术后妊娠,孕期靶肌瘤增长程度对妊娠结局无不良影响。
[Abstract]:Objective to investigate the outcome and pregnancy outcome of target myoma in pregnancy after high intensity focused ultrasound (HIFU) ablation of uterine leiomyoma. Methods 123 cases of pregnancy after HIFU in our hospital were selected and the clinical data were collected. Results the median follow-up time was 3 years. Compared with pre-pregnancy, 60 cases (60 / 123) with target leiomyoma increased in the second trimester of pregnancy. In 22 patients with target leiomyoma removed by cesarean section with an average diameter of 2.1 卤1.6 cm ~ (-1), there were 3 / 22 / 2213.63 / 13 cases with 13 / 2259.09% of 13 / 22 / 2259.09) respectively, compared with those before and in the second trimester of pregnancy; in 27 cases of B-ultrasound reexamination after 3 months of postpartum, the target fibroids were compared with those before and in the second trimester of pregnancy. There were 12 cases of 12 / 27 / 27 44.44 cases with 18 cases of 18 cases of 18 / 2766.67 cases of target myoma shrinking. Of the 123 cases of pregnancy after HIFU, 84 cases were successfully delivered, 18 cases were pregnant, 4 cases were induced abortion, 17 cases were spontaneous abortion, the history of pregnancy loss before operation and age in the patients with successful delivery and spontaneous abortion. There were significant differences in the number of leiomyomas and the incidence of leiomyoma enlargement during pregnancy (P < 0.05), but there was no significant difference in the increase of target leiomyoma during pregnancy (P < 0.05). Conclusion after ultrasound ablation of uterine leiomyoma, some target leiomyomas are temporarily increased in the first and second trimester of pregnancy. But it was still smaller than the maximum diameter of the target leiomyoma before HIFU, and there was no significant change in the target myoma in the third trimester than in the early and second trimester of pregnancy. The postpartum target myoma showed a decreasing trend of pregnancy. The growth of the target leiomyoma during pregnancy had no adverse effect on the outcome of pregnancy.
【作者单位】：重庆医科大学生物医学工程学院省部共建国家重点实验室培育基地—重庆市超声医学工程重点实验室重庆市生物医学工程学重点实验室;重庆医科大学附属第一医院超声消融治疗中心;
【基金】：国家“十二五”科技支撑计划课题项目(2011BAI14B01)
【分类号】：R445.1;R737.33

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