丙酸睾丸酮在高强度聚焦超声治疗子宫肌瘤中的临床应用

发布时间：2018-06-09 04:04

本文选题：子宫 + 平滑肌瘤　；参考：《中国介入影像与治疗学》2015年10期

【摘要】：目的探讨高强度聚焦超声(HIFU)治疗子宫肌瘤前辅助应用丙酸睾丸酮的临床价值。方法将60例子宫肌瘤患者随机分为两组,HIFU治疗前联合丙酸睾丸酮治疗(研究组)或仅接受单纯HIFU治疗(对照组)。观察并记录HIFU治疗参数指标、发生凝固性坏死时的声像图灰阶改变、术中不良反应及术后并发症,测量并计算肌瘤内无灌注区体积、消融率、治疗后6个月子宫体积缩小率及肌瘤体积缩小率,并进行统计学分析。结果两组间HIFU治疗的治疗功率、治疗时间、辐照时间、治疗强度、治疗剂量差异均无统计学意义(P均0.05)。研究组出现团状强回声的比例[53.33%(16/30)]高于对照组[26.67%(8/30),2χ=4.444,P=0.035]。两组间出现团状强回声的辐照时间、治疗过程中患者不良反应、治疗后肌瘤内无灌注区体积、消融率、治疗后6个月子宫体积缩小率及肌瘤体积缩小率差异均无统计学意义(P均0.05)。两组中HIFU治疗后并发症患者均经对症治疗后好转,无严重并发症发生。结论 HIFU治疗子宫肌瘤前辅助应用丙酸睾丸酮并不能有效提高消融率及治疗后肌瘤体积缩小率,但在一定程度上有利于治疗中团状强回声的出现。
[Abstract]:Objective to evaluate the clinical value of high intensity focused ultrasound (HIFU) in the treatment of uterine leiomyoma with adjunctive application of testosterone propionate. Methods Sixty patients with uterine leiomyoma were randomly divided into two groups before and after treatment with HIFU combined with testosterone propionate (study group) or only treated with HIFU alone (control group). The parameters of HIFU were observed and recorded. The changes of sonogram gray scale, intraoperative adverse reactions and postoperative complications were observed and recorded. The volume of no perfusion area and the ablation rate were measured and calculated. Uterine volume reduction rate and myoma volume reduction rate were statistically analyzed 6 months after treatment. Results there was no significant difference in power, time, irradiation time, intensity and dose of HIFU between the two groups (P < 0.05). The proportion of massive strong echo in the study group [53.33% 16 / 30] was higher than that in the control group [26.67%] [26.67%]. The irradiating time of massive strong echo between the two groups, the adverse reaction of the patients during the treatment, the volume of no perfusion area and the ablation rate in the myoma after treatment. There was no significant difference in uterine volume reduction rate and myoma volume reduction rate at 6 months after treatment (P < 0.05). The complications of HIFU were improved after HIFU treatment, and no serious complications occurred. Conclusion Adjuvant application of testosterone propionate before treatment with HIFU can not effectively increase the ablation rate and the reduction rate of myoma volume after treatment, but to a certain extent is conducive to the appearance of massive hysteric echo in the treatment of uterine leiomyoma.
【作者单位】：重庆医科大学生物医学工程学院省部共建超声医学工程国家重点实验室超声医学工程重庆市重点实验室;
【基金】：国家重点基础研究发展计划(973计划)项目(2011CB707900) 2011年高等学校博士学科点专向科研基金联合资助课题(20115503110014)
【分类号】：R737.33;R445.1

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