HIFU治疗症状性子宫肌瘤疗效观察及其影响贫血改善因素的探讨

发布时间：2018-04-05 20:24

本文选题：HIFU　切入点：子宫肌瘤　出处：《重庆医科大学》2014年硕士论文

【摘要】：子宫肌瘤作为最常见的女性生殖系统良性肿瘤，多见于30～50岁妇女,发病率占育龄妇女的20%～40%。其常见的临床症状有月经过多、盆腔受压、疼痛及影响生育能力等，其中月经过多最为常见。临床治疗的主要目的是缓解临床症状、改善生活质量及减轻患者的心理负担。高强度聚焦超声（HIFU）消融治疗作为治疗子宫肌瘤的一种全新方式，其安全性及有效性已通过前期大量的临床研究得以证实。但HIFU治疗因子宫肌瘤引起月经量过多而导致贫血症状的临床效果及其相关影响因素仍需要更加具体深入的研究和探讨，为进一步提高临床疗效、制定临床治疗方案提供参考。目的 1.分析HIFU治疗对于改善子宫肌瘤相关症状的整体效果，并定量评价HIFU治疗对于改善子宫肌瘤引起月经过多而导致贫血的效果。 2.初步探讨对于HIFU治疗能否改善月经过多导致的贫血有影响的因素。资料和方法回顾性分析2011年1月至2012年1月在重庆医科大学附属第一医院接受HIFU治疗的75例单发子宫肌患者的治疗前临床症状评分、血常规和盆腔MRI检查结果，治疗后24小时内复查的盆腔MRI检查结果，以及治疗后6月随访的临床症状评分和复查的血常规、盆腔MRI检查结果。通过对比治疗前后症状评分及相关检查结果，整体评价HIFU治疗对于改善子宫肌瘤相关临床症状的治疗效果，并定量评价HIFU治疗对于改善子宫肌瘤引起月经过多而导致贫血的效果并探索相关影响因素。结果 1.HIFU治疗75例子宫肌瘤的消融率中位数为82%（73%-93%）；消融率大于70%的患者共61例，占81.33%。 2.HIFU治疗对于子宫肌瘤引起的临床症状的缓解率为86.67%，治疗后症状评分较治疗前平均降低31.3%。 3.HIFU治疗对于月经过多导致贫血的总改善率为85.4%，治疗后6月患者血红蛋白水平较治疗前平均上升22g/L。 4.HIFU治疗后患者血红蛋白改善值与消融率正相关，且两者之间的定量关系：Y=－11.767+41.46X（Y：HIFU治疗后6月血红蛋白改善值，X：消融率）。结论 1.HIFU治疗能够有效改善子宫肌瘤的相关临床症状。 2.HIFU治疗对于改善子宫肌瘤引起月经过多而导致贫血的临床效果明显。 3.消融率对于子宫肌瘤引起月经过多而导致的贫血的改善情况有一定影响，并初步提示消融率越高，，其改善程度越明显。
[Abstract]:High - intensity focused ultrasound ( HIFU ) ablation therapy is a new way to treat uterine fibroids , and its safety and effectiveness have been confirmed by a large number of clinical studies .

Purpose

1 . To analyze the overall effect of HIFU treatment for improving the symptoms associated with uterine fibroids , and to quantitatively evaluate the effect of HIFU treatment on improving uterine fibroids and causing anemia .

2 . To explore the factors influencing the effect of HIFU treatment on anemia caused by excessive menstruation .

Materials and Methods The results of pre - treatment clinical symptom score , blood routine and pelvic MRI examination were analyzed retrospectively from January 2011 to January 2012 in the First Affiliated Hospital of Chongqing Medical University . The results of pelvic MRI examination were reviewed in 24 hours after treatment .

Results

1 . The median ablation rate of HIFU in 75 cases of uterine fibroids was 82 % ( 73 % -93 % ) ;
There were 61 patients with ablation rate greater than 70 % , accounting for 81.33 % .

2 . The remission rate of HIFU in the treatment of uterine fibroids was 86.67 % , and the symptom score after treatment decreased by 31.3 % before treatment .

3 . The overall improvement rate of HIFU treatment for anemia was 85.4 % , and the level of hemoglobin increased by 22 g / L before treatment in June after treatment .

4 . After HIFU treatment , the patient ' s hemoglobin improvement value was positively correlated with the ablation rate , and the quantitative relationship between them was : Y = - 11.767 + 41.46X ( Y : hemoglobin improvement after HIFU treatment , X : ablation rate ) .

Conclusion

1 . HIFU treatment can effectively improve the associated clinical symptoms of uterine fibroids .

2 . HIFU treatment has obvious clinical effect on improving uterine fibroids and causing anemia .

3 . The ablation rate has some influence on the improvement of anemia caused by uterine fibroids , and the higher the ablation rate , the more obvious the improvement degree is .

【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.33

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