高强度聚焦超声治疗产后胎盘植入22例临床研究-妇产科学专业论文.docxVIP

重庆医科 重庆医科大学硕士研究生学位论文 万方数据 万方数据 高强度聚焦超声治疗产后胎盘植入 22 例临床研究 摘要1 目的: 探讨高强度聚焦超声治疗产后胎盘植入的有效性、安全性 及临床应用价值。 方法:选取2011年9月～2013年3月于我院就诊或外院转诊的22例 产后胎盘植入患者为研究对象，在超声实时监控下进行高强度聚焦超 声治疗，并通过盆腔彩色多普勒超声及核磁共振成像检查对比治疗前 后胎盘植入区域血流灌注变化情况，以了解治疗效果。随访实验室及 影像学相关检查、残留胎盘组织排出、月经复潮及再次妊娠情况。 结果:22例患者均顺利完成高强度聚焦超声治疗，治疗后即行盆腔 彩色多普勒超声，显示胎盘植入区域血流灌注明显减少甚至消失，核 磁共振增强扫描显示胎盘植入区域未见明显强化。治疗前后患者血常 规、肝肾功能以及凝血功能等未见明显变化，对卵巢内分泌功能无明 显影响。20例坏死胎盘组织自行排出，2例行辅助性清宫术，18例月经 已复潮，1例成功再次妊娠。 结论:高强度聚焦超声是治疗产后胎盘植入的一种新型非侵入性 方式，具有良好的有效性、安全性及临床推广应用价值。 关键词：胎盘植入，高强度聚焦超声，非侵入性治疗，临床研究 1 国家自然科学基金资助项目（NO 1 A CLINICAL STUDY OF HIGH-INTENSITY FOCUSED ULTRASOUND ABLATION FOR THE TREATMENT OF TWENTY-TWO PATIENTS WITH PLACENTA ACCRETA ABSTRACT Objective: To evaluate the clinical safety and efficacy and application value of high-intensity focused ultrasound in the treatment of placenta accreta. Methods: Between September 2011 and March 2013, twenty-two patients with placenta accreta were treated under the ultrasound real-time monitoring of HIFU in the First Affiliated Hospital of Chongqing Medical University. Before and after the HIFU treatment, color doppler ultrasound and magnatic resonance imaging were performed. The blood perfusion of placental tissues, the laboratory and imaging examinations, and the excretion of placental tissue were also observed as well as the time of return of normal menstruation and the reproductive ability. Results: All patients have finished the treatment of HIFU. After the treatment ，the blood perfusion of placental tissues were significantly reduced or even disappeared. Twenty cases of placental tissues have completely excreted, and two cases received uterine curettage. In addition, eighteen cases resumed normal menstruation and one case was interuterine 2 repregnant. Conclusions: HIFU is a non-invasive treatment for placenta accreta, which possesses safety and efficacy, and has the clinical value. Key words: placenta accreta, high-intensity focused ultrasound, non-invasive treatment, clinical resear