探讨六氟化硫微泡在高强度聚焦超声治疗子宫肌瘤中的临床应用价值(1)
【摘 要】目的:分析高强度聚焦超声(HIFU)治疗子宫肌瘤中六氟化硫微泡的临床价值。方法:选取2018年5月-2018年11月医院收治的76例子宫肌瘤患者作为研究对象,随机数字表分成观察组、对照组各38例。对照组为术中造影,观察组术前、术中、术后均采用六氟化硫微泡造影。比较两组手术时间、辐照时间、治疗剂量、并发症情况等。结果:观察组患者手术时间、辐照时间及治疗剂量均低于对照组,差异显著有统计学意义(P<0.05)。观察组并发症发生率为2.6%、对照组15.8%,差异有统计学意义(P=0.04733)。结论:六氟化硫微泡造影的HIFU在子宫肌瘤治疗中具有安全、快速等优势,值得推广。
【关键词】子宫肌瘤;六氟化硫微泡;高强度聚焦超声
Abstract Objective:To analyze the clinical value of high intensity focused ultrasound (HIFU) in the treatment of sulfur hexafluoride microbubbles in uterine leiomyoma. Methods:76 patients with uterine leiomyoma admitted to our hospital from May 2018 to November 2018 were selected as the study subjects. The patients were randomly divided into observation group and control group with 38 cases in each group. The control group underwent intraoperative angiography, while the observation group underwent sulfur hexafluoride microbubble angiography before, during and after operation. The operation time, irradiation time, treatment dose and complications were compared between the two groups. Results:The operation time, irradiation time and treatment dose of the observation group were lower than those of the control group, and the difference was significant (P < 0.05). The incidence of complications was 2.6% in the observation group and 15.8% in the control group (P=0.04733). Conclusion: HIFU with sulfur hexafluoride microbubbles has advantages of safety and rapidity in the treatment of uterine leiomyoma, and it is worth popularizing.
Key words: uterine leiomyoma; sulfur hexafluoride microbubbles; high intensity focused ultrasound
【中圖分类号】 R737.66【文献标识码】 B【文章编号】 1672-3783(2019)05-03-072-01
子宫肌瘤是育龄期女性中一种常发的良性肿瘤,高强度聚焦超声(HIFU)作为当前临床治疗子宫肌瘤的一种安全、有效的微创方式,在临床中取得了不斐成绩[1]。为进一步分析采用六氟化硫微泡造影指导HIFU治疗子宫肌瘤的效果,笔者特在2018年5月-2018年11月收治的76例子宫肌瘤患者中进行了研究和分析,现报道如下。
1 受试对象与方法
1.1 受试者资料 选取2018年5月-2018年11月医院收治的76例子宫肌瘤患者,随机数字表分成观察组、对照组各38例。对照组患者年龄为21-50岁,平均(40.7±4.3)岁;肌瘤体积62.5-256.5cm3,平均(113.2±7.5)cm3。观察组年龄为20-49岁,平均(41.3±4.8)岁;肌瘤体积63.7-253.7cm3,平均(112.5±6.9)cm3。对比两组患者年龄、肌瘤体积,差异均无统计学意义(P<0.05)。
1.2 病例入选标准 纳入标准[2]:①临床确诊子宫肌瘤,单发肌瘤最大径5-8cm;②患者期望保留子宫;③无MR检查禁忌症。排除腹部放疗史、盆腔炎畸形发作、宫颈肌瘤、多发性子宫肌瘤等患者。
1.3 方法 所有患者术前非月经期采用憋尿定位,经灰阶彩色多普勒超声对病位大小、回声特点、边界、数量、血供情况等进行观察,判定其与周围脏器的关系,并初步判断和分级。观察组术前、术中、术后均采用六氟化硫微泡造影,采用由重庆海扶公司提供的JC型HIFC治疗仪,由点到线、由线到面、由局部到整体进行治疗。对照组为术中造影,术前、术后均采用飞利浦MRI3.0T进行盆腔的扫描检查。当肌瘤病灶可见团块状灰度变化、整体灰度增加时,以六氟化硫微泡造影1.5ml,确定非灌注区后,记录前后径等。
1.4 疗效指标 比较两组手术时间、辐照时间、治疗剂量、并发症(全身酸麻、下肢麻木、治疗区皮肤Ⅱ度烧伤)情况等。
1.5 统计学分析, 百拇医药(唐波)
【关键词】子宫肌瘤;六氟化硫微泡;高强度聚焦超声
Abstract Objective:To analyze the clinical value of high intensity focused ultrasound (HIFU) in the treatment of sulfur hexafluoride microbubbles in uterine leiomyoma. Methods:76 patients with uterine leiomyoma admitted to our hospital from May 2018 to November 2018 were selected as the study subjects. The patients were randomly divided into observation group and control group with 38 cases in each group. The control group underwent intraoperative angiography, while the observation group underwent sulfur hexafluoride microbubble angiography before, during and after operation. The operation time, irradiation time, treatment dose and complications were compared between the two groups. Results:The operation time, irradiation time and treatment dose of the observation group were lower than those of the control group, and the difference was significant (P < 0.05). The incidence of complications was 2.6% in the observation group and 15.8% in the control group (P=0.04733). Conclusion: HIFU with sulfur hexafluoride microbubbles has advantages of safety and rapidity in the treatment of uterine leiomyoma, and it is worth popularizing.
Key words: uterine leiomyoma; sulfur hexafluoride microbubbles; high intensity focused ultrasound
【中圖分类号】 R737.66【文献标识码】 B【文章编号】 1672-3783(2019)05-03-072-01
子宫肌瘤是育龄期女性中一种常发的良性肿瘤,高强度聚焦超声(HIFU)作为当前临床治疗子宫肌瘤的一种安全、有效的微创方式,在临床中取得了不斐成绩[1]。为进一步分析采用六氟化硫微泡造影指导HIFU治疗子宫肌瘤的效果,笔者特在2018年5月-2018年11月收治的76例子宫肌瘤患者中进行了研究和分析,现报道如下。
1 受试对象与方法
1.1 受试者资料 选取2018年5月-2018年11月医院收治的76例子宫肌瘤患者,随机数字表分成观察组、对照组各38例。对照组患者年龄为21-50岁,平均(40.7±4.3)岁;肌瘤体积62.5-256.5cm3,平均(113.2±7.5)cm3。观察组年龄为20-49岁,平均(41.3±4.8)岁;肌瘤体积63.7-253.7cm3,平均(112.5±6.9)cm3。对比两组患者年龄、肌瘤体积,差异均无统计学意义(P<0.05)。
1.2 病例入选标准 纳入标准[2]:①临床确诊子宫肌瘤,单发肌瘤最大径5-8cm;②患者期望保留子宫;③无MR检查禁忌症。排除腹部放疗史、盆腔炎畸形发作、宫颈肌瘤、多发性子宫肌瘤等患者。
1.3 方法 所有患者术前非月经期采用憋尿定位,经灰阶彩色多普勒超声对病位大小、回声特点、边界、数量、血供情况等进行观察,判定其与周围脏器的关系,并初步判断和分级。观察组术前、术中、术后均采用六氟化硫微泡造影,采用由重庆海扶公司提供的JC型HIFC治疗仪,由点到线、由线到面、由局部到整体进行治疗。对照组为术中造影,术前、术后均采用飞利浦MRI3.0T进行盆腔的扫描检查。当肌瘤病灶可见团块状灰度变化、整体灰度增加时,以六氟化硫微泡造影1.5ml,确定非灌注区后,记录前后径等。
1.4 疗效指标 比较两组手术时间、辐照时间、治疗剂量、并发症(全身酸麻、下肢麻木、治疗区皮肤Ⅱ度烧伤)情况等。
1.5 统计学分析, 百拇医药(唐波)