摘要
目的评估超声引导下射频消融治疗子宫肌瘤的临床疗效与安全性。方法对解放军85医院自2012年3月至2013年3月收治的148例子宫肌瘤患者进行超声引导下射频消融治疗。记录患者术前的主要症状。术前及术后3、6、12个月行阴式B超检查,观察肌瘤的位置,测量肌瘤3条径线长度,计算平均肌瘤体积及肌瘤缩小率。在术前及术后12个月采用子宫肌瘤症状及健康相关生活质量问卷(UFS-HRQL)评估子宫肌瘤相关症状及生活质量改善情况。观察术后12个月内术并发症发生情况。结果术前,术后3、6、12个月肌瘤平均体积分别为(23.33±22.80)cm^3、(12.47±11.83)cm^3、(6.88±6.52)cm^3及(4.45±4.26)cm^3;各术后组与术前组肌瘤平均体积比较,差异均有统计学意义(P<0.05)。术后3、6、12个月肌瘤缩小率分别为49.6%、70.3%、80.3%。117例有症状的患者中,术前、术后12个月平均UFS评分分别为(33.51±13.94)分、(5.77±4.50)分;平均QOL评分为分别为(68.09±15.17)分、(90.79±5.52)分;术前、术后UFS评分及QOL评分比较,差异均有统计学意义(P<0.05)。随访12个月,无严重并发症发生。结论 B超引导下射频消融子宫肌瘤对于无生育要求的、肌瘤较小(直径<6.5 cm)、随访条件好的患者,是一种临床价值较高的治疗手段,值得推广应用。
Objective To evaluate the clinical effect and safety of ultrasound-guided radiofrequency ablation. Methods Ultrasoundguided radiofrequency ablation was performed with 148 patients for uterine myoma from March 2012 to March 2013. The main symptoms were recorded before the operation. The location of the myoma was observed by ultrasonography. The three dimensions of the myoma was measured and the volume of it was calculated before and after the operation at 3,6 and 12 months. The volume reduction rate of it was calculated accordingly. The relief of the related symptoms and the life quality improvement was evaluated using UFS-HROL questionnaire before and after the operation at 12 months. The postoperative complication were recorded within 12 months after the operation. Results The mean volume of the myoma before and after the operation at 3,6 and 12 months was（ 23. 33 ± 22. 80） cm^3,（ 12. 47 ± 11. 83） cm^3,（ 6. 88 ± 6. 52） cm^3and（ 4. 45 ± 4. 26） cm^3,respectively. There was a statistically significant difference between preoperative group and each postoperative group（ P 〈 0. 05）. The volume reduction rate was 49. 6%,70. 3% and 80. 3% at 3,6 and12 months after the operation. Among 117 symptomatic patients,the mean UFS scores before and after the operation at 12 months was（ 33. 51 ± 13. 94） scores and（ 5. 77 ± 4. 50） scores; the mean QOL scores before and after the operation at 12 months was（ 68. 09 ±15. 17） scores and（ 90. 79 ± 5. 52） scores; there was statistically significant difference between UFS score and QOL score before and after operation（ P 〈 0. 05）. No major complications were observed or reported within 12 months after the operation. Conclusion Ultrasound-guided radiofrequency ablation deserves popularization for its clinical value to those who has no desired future fertility,with myoma smaller than 6. 5 cm in diameter with good follow-up examination.
作者
孙健
曾燕敏
陈军霞
肖文庭
王琼
刘全英
张烨敏
SUN Jian ZENG Yan-min CHEN Jun-xia XIAO Wen-ting WANG Qiong LIU Quan-ying ZHANG Ye-min(Department of Obstetrics and Gynecology, No. 85 Hospital of PLA, Shanghai 200052, Chin)
出处
《临床军医杂志》
CAS
2017年第7期664-667,共4页
Clinical Journal of Medical Officers
关键词
B超引导
射频消融
子宫肌瘤
肌瘤体积
子宫肌瘤症状及健康相关生活质量问卷
Ultrasound-guided
Radiofrequency ablation
Myoma
The volume of the myoma
Uterine fibroid symptom and health-related quality of life scores
