（子宫腺肌病超声消融有效性和安全性研究.docVIP

(子宫腺肌病超声消融有效性及安全性研究 周敏1，陈锦云2，唐良萏1，张蓉3，陈文直2，王智彪2（1重庆医科大学附属第一医院妇产科，重庆400016，2重庆医科大学生物医学工程系、超声医学工程－省部共建国家重点实验室， 重庆 400016，3超声医疗国家工程研究中心，重庆 401121） 探讨超声消融子宫腺肌病的有效性和安全性。 对重庆医科大学附属第一医院2007年3月至2008年9月期间78例以痛经为主伴有或不伴有经量增多的子宫腺肌病患者行超声消融治疗，评价患者对治疗的耐受性，定期随访治疗后症状变化，记录治疗后6月内不良反应发生情况，增强MRI评价治疗前后病灶凝固性坏死情况。 78例患者中疼痛评分4分以下者占84.6%，其中1例因血压升高不能缓解而终止治疗；具有完整随访资料的患者69例，平均随访时间11.9±6.4月。治疗前后月经量评分和痛经评分降低，差异具有显著性（P0.05）；62例痛经症状得到不同程度缓解，总有效率89.9％；69位患者中22人（32%）发生不良反应，其中4人发生2种以上。27人次数不良反应中23例（85.1％）为SIR A类；4例（14.8％）SIR B类不良反应对症处理后均恢复；全部病例均无严重的不良事件发生，亦无住院时间延长或再次入院。60例增强MRI可见无灌注区域，凝固性坏死发生率为87.0％，无灌注区大小和病灶部位与不良反应发生均无相关性（P0.05）。 超声消融是一种安全有效的治疗方式，可成为子宫腺肌病可供选择的一种新型无创治疗方式。 子宫腺肌病；超声消融；有效性；安全性 The Safety And Efficacy of Ultrasound Ablation for AdenomyosisZHOU Min1, CHEN Jinyun2,TANG Liangdan1,ZHANG Rong3, CHEN Wenzhi2, WANG Zhibiao2 1 Department of Obstetrics ＆ Gynecology, First Affiliated Hospital, 2Biomedical Engineering Department, State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and MOST, Chongqing Medical University, Chongqing, 400016, China, 3National Engineering Research Center of Ultrasound Medicine , Chongqing, 401121, China 【Abstract】 Objective To identify safety and efficacy of high intensity focused ultrasound ablation in treatment of adenomyosis. Methods Ultrasound ablation was performed in 78 patients with symptomatic adenomyosis in first affiliated hospital of Chongqing medical university from Mar 2007 to Oct 2008. All patients were surveyed regarding their pain levels using numeric rating scale (NRS) ranging from zero to 10 after the treatment immediately. Enhanced magnetic resonance imaging (MRI) was performed 0-3 months after the treatment according to imaging parameter pre-treatment used to assess coagulative necrosis . Clinical evaluation using a standardized questionnaire was made at regular intervals after ultrasound ablation to assess patient outcome. Each complication was categorized and graded as to severity and outcome using the compl