| 摘要: |
| 目的：探讨子宫肌瘤患者高强聚焦超声(high intensity focused ultrasound, HIFU) 治疗后妊娠情况及影响因素，为优化子宫肌瘤患者治疗方案提供理论依据。方法：纳入2014年6月至2017年6月因子宫肌瘤行海扶手术治疗的98例有生育要求的患者，定期随访，了解术后妊娠情况及产科并发症发生情况。结果：（1）截止2018年6月，本研究98例患者共有71例患者89次妊娠。妊娠组与非妊娠组在年龄及不孕时间上差异有统计学意义（P＜0.05），肌瘤大小和肌瘤类型、孕产次等差异无统计学意义（P＞0.05）。（2）89次妊娠结局为分娩68次（顺产21次，剖宫产47次），自然流产9次，人工流产4次，中孕畸形引产1次，宫外孕1次，6例妊娠中。（3）68次分娩发生产科并发症12例，其中早产2例，中央性前置胎盘2例，边缘性前置胎盘3例，胎盘植入2例，胎盘粘连3例。（4）不同类型肌瘤术后妊娠时产科并发症发生率有明显差异（P＜0.05），主要表现为前置胎盘、胎盘粘连和胎盘植入。结论：HIFU治疗子宫肌瘤安全有效，可作为有生育要求患者治疗子宫肌瘤的新选择。 |
| 关键词: 宫肌瘤 高强聚焦超声 妊娠结局 |
| DOI： |
| 投稿时间：2019-01-09修订日期：2020-09-24 |
| 基金项目: |
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| Analysis of pregnancy and its influencing factors in patients with uterine fibroids after high intensity focused ultrasound therapy |
| hu chang |
| () |
| Abstract: |
| Objective To investigate the pregnancy status and influencing factors of patients with uterine fibroids after high-intensity focused ultrasound(HIFU) therapy, and to provide theoretical basis for optimizing the treatment of patients with uterine fibroids. Methods Ninety-eight patients with fertility requirements who underwent hysteroscopic surgery for uterine fibroids from June 2014 to June 2017 were enrolled. Regular follow-up was conducted to understand postoperative pregnancy and obstetric complications. Results (1) As of June 2018, 98 patients in this study had a total of 71 patients with 89 pregnancies. There was significant difference in age and infertility between the pregnant group and the non-pregnant group (P<0.05). There was no significant difference in the size of fibroids, type of fibroids and maternal parity (P>0.05). (2) 89 pregnancy outcomes were 68 births (21 births, 47 cesarean section), 9 spontaneous abortions, 4 abortions, 1 induction of abnormality in mid-pregnancy, 1 ectopic pregnancy, and 6 cases of pregnancy. (3) There were 12 complications in 68 births, including 2 cases of premature delivery, 2 cases of central placenta previa, 3 cases of marginal placenta previa, 2 cases of placenta implantation, and 3 cases of placenta adhesion. (4) Obstetric complications of submucosal fibroids were significantly increased compared with the other groups, the difference was statistically significant (P<0.05), mainly manifested as placenta previa, placental adhesion and placenta implantation. Conclusion HIFU is safe and effective in the treatment of uterine fibroids. It can be used as a new option for the treatment of uterine fibroids in patients with fertility requirements. |
| Key words: Uterine fibroids, High intensity focused ultrasound ,Pregnancy outcome |
