摘要
目的:观察子宫肌瘤患者接受子宫肌瘤高强度聚焦超声(HIFU)和子宫肌瘤挖除治疗术后的妊娠功能及术后并发症情况。方法:纳入2020年2月-2023年2月本院收治的子宫肌瘤患者85例,患者术后均存在强烈的生育意愿。根据治疗方案分为HIFU组(n=42,行子宫肌瘤HIFU治疗)和挖除组(n=43,行子宫肌瘤挖除术治疗)。观察两组临床指标(住院时间、康复时间、失血量、手术时间)及患者术后3个月月经周期2~4d时性激素水平,子宫动脉血流参数(血流灌注指数、阻力指数、子宫动脉血流量),记录术后并发症及术后2年妊娠情况。结果:HIFU组住院时间、康复时间、手术时间均短于挖除组,失血量低于挖除组(P<0.05)。治疗后两组血清促卵泡激素、促黄体生成激素、泌乳素、雌二醇水平均降低(P<0.05),但两组无差异(P>0.05);两组血流灌注指数、阻力指数、子宫动脉血流量均降低(P<0.05),但两组无差异(P>0.05);HIFU组术后并发症总发生率(7.1%)低于挖除组(23.3%),妊娠成功率(45.2%)高于挖除组(20.9%)(均P<0.05),术后2年复发率、受孕方式、分娩方式及不良妊娠结局发生率两组均无差异(P>0.05)。结论:相较于子宫肌瘤挖除术,HIFU治疗在术后恢复、并发症发生率和手术风险方面具有明显优势,且对患者的妊娠能力无显著影响,可作为具有生育意愿的子宫肌瘤患者的有效治疗选择。
Objective:To observe the pregnancy function and the postoperative complications situation of the high-intensity focused ultrasound(HIFU)or the myomectomy for treating patients with uterine fibroids.Methods:A total of 85 patients with uterine fibroids who had a strong desire to conceive after surgery admitted to the hospital were included and were divided into group A(42 cases with the treatment of uterine fibroids by HIFU)and group B(43 cases with the myomectomy)according to the different treatment plan from February 2020 to February 2023.The values of the clinical indicators(the hospitalization time,the recovery time,the blood loss and the surgery time),the sex hormone levels on the second day to the fourth day of the menstrual cycle in 3 months after surgery,the values of the uterine artery blood flow parameters(the blood perfusion index,the resistance index and the uterine artery blood flow volume)of the patients were compared between the two groups.The postoperative complications occurrence and the pregnancy status of the patients within 2 years after surgery were recorded.Results:The hospitalization time,the rehabilitation time and the operation time of the patients in group A were significantly shorter than those of the patients in group B,and the blood loss of the patients in group A was significantly lower than that of the patients in group B(P<0.05).After treatment,the levels of the serum follicle-stimulating hormone,luteinizing hormone,prolactin and estradiol of the patients in the two groups had decreased significantly(P<0.05),but which of the patients had no significantly different between the two groups(P>0.05).The values of the blood perfusion index,resistance index and uterine artery blood flow of the patients in the two groups had decreased significantly(P<0.05),but which of the patients had no significantly different between the two groups(P>0.05).The total incidence of the postoperative complications(7.1%)of the patients in group A was significantly lower than that(23.3%)of the patients in group B(P<0.05),and the success rate of pregnancy(45.2%)of the patients in group A was significantly higher than that(20.9%)of the patients in group B(P<0.05).There were no significant differences in the recurrence rate of uterine fibroids within 2 years after surgery,the mode of conception,the mode of delivery and the incidence of adverse pregnancy outcomes of the patients between the two groups(P>0.05).Conclusion:Compared with those of the myomectomy,HIFU treatment for the patients with uterine fibroids has obvious advantages in the postoperative recovery,the complication rate and the surgical risk of the patients,and which has no significant effects on the ability of pregnancy of the patients and can be used as an effective treatment option for the patients with uterine fibroids who have fertility intentions.
作者
王佳雯
程静新
丁薇薇
刘春梓
肖逸静
段文芝
WANG Jiawen;CHENG Jingxin;DING Weiwei;LIU Chunzi;XIAO Yijing;DUAN Wenzhi(Shanghai East Hospital,Shanghai,200120)
出处
《中国计划生育学杂志》
2025年第6期1266-1270,共5页
Chinese Journal of Family Planning
关键词
子宫肌瘤
高强度聚焦超声
子宫肌瘤挖除术
术后恢复
性激素
妊娠率
并发症
Uterine fibroid
High-Intensity Focused Ultrasound
Myomectomy
Postoperative recovery
Sex hormone
Pregnancy rate
Complication
