| 摘要: |
| 目的：探讨高强度聚焦超声（HIFU）治疗对保守治疗痛经缓解后再发的子宫腺肌病患者的有效性。方法：纳入2020年10月至2022年04月期间，在广西壮族自治区人民医院妇科诊断为子宫腺肌病，且既往曾接受过一种或多种保守治疗方法后再发并愿意接受HIFU治疗的患者。HIFU消融过程中采用实时超声确定靶区位置，在消融治疗前和治疗后即刻均行超声造影检查评价消融率。收集患者治疗前及治疗后3、6、12、24个月的痛经情况，并计算疼痛减轻百分数。患者痛经症状较术前缓解时间超过6个月被认为治疗有效，后期再次出现中度以上的痛经被认为再发。结果：总计纳入92名患者，经HIFU治疗后即刻超声造影提示平均消融率为76.67±6.22%。治疗后3月、6月、12月、18月及24月痛经缓解率分别为88.04 %、75.00 %、55.43 %、42.86 %及32.97 %。结论：HIFU治疗对保守治疗痛经缓解后再发的的子宫腺肌症患者安全有效，短期有效率高，可作为年轻且希望保留子宫患者的一种治疗选择。 |
| 关键词: 高强度聚焦超声消融 子宫腺肌病 痛经 再发 缓解率 |
| DOI： |
| 投稿时间：2024-05-06修订日期：2024-05-24 |
| 基金项目:广西医疗卫生适宜技术开发与推广应用项目(项目编号：S2020082) |
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| Efficacy of High-Intensity Focused Ultrasound Ablation for Treating Recurrent Adenomyosis: A Prospective Cohort Study |
| Zeng Jinghua,Zeng Jinghua,Huang Fengye,Zhang Jing,Yang Liu |
| (Department of Gynecology, The People''s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, 530021 China.) |
| Abstract: |
| Objective: To explore the effectiveness of high-intensity focused ultrasound (HIFU) ablation in patients with adenomyosis who have experienced treatment failure with conservative methods. Methods: Patients diagnosed with adenomyosis at the Department of Obstetrics and Gynecology of the People's Hospital of Guangxi Zhuang Autonomous Region from October 2020 to April 2022, who had experienced recurrent adenomyosis and were willing to undergo HIFU treatment were included in this study. Real-time ultrasound was used to determine the target area during the HIFU ablation process, and ultrasound contrast imaging was performed immediately before and after treatment to evaluate the ablation rate. Dysmenorrhea symptoms were collected before treatment and at 3, 6, 12, and 24 months after treatment, and the percentage of pain relief was calculated. Pain relief lasting more than 6 months after the operation was considered effective, while the recurrence of moderate or severe dysmenorrhea was classified as recurrence. Results: A total of 92 patients were included in this study, with an average ablation rate of 76.67±6.22% immediately after HIFU treatment as indicated by ultrasound imaging. Dysmenorrhea relief rates at 3, 6, 12, 18, and 24 months post-treatment were 88.04%, 75.00%, 55.43%, 42.86%, and 32.97%, respectively. Conclusion: HIFU treatment is safe and effective for patients with adenomyosis who experience recurrence of dysmenorrhea after conservative treatment. It has a high short-term efficacy rate and can be considered a treatment option for young patients who wish to preserve their uterus. |
| Key words: High-Intensity Focused Ultrasound Ablation Adenomyosis Dysmenorrhea Recurrence Relief Rate |
