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目的探讨自凝刀射频消融术联合米非司酮治疗子宫肌瘤的疗效,可行性及安全性。方法选择2008年至2011年在我院行射频消融术联合米非司酮治疗的子宫肌瘤患者90例,其中黏膜下肌瘤22例,肌壁间肌瘤47例,浆膜下肌瘤21例,单发肌瘤51例,多发肌瘤39例,直径≥2cm,≤8cm,进行临床分析。结果术后3个月复查:①58例完全治愈(标准:肌瘤完全消失或肌瘤直径减少80%以上,无临床症状)。②好转25例(标准:肌瘤直径减少50%~80%,临床症状好转)。③有效6例(标准:肌瘤直径减少20%~50%,临床症状有所好转)。④无效1例(标准:肌瘤直径减少20%以下,临床症状无改善。)再次手术,肌瘤直径减少50%以上,临床症状明显改善,总的有效率达100%。结论自凝刀射频消融术联合米非司酮治疗子宫肌瘤是安全可行的,疗效是肯定的。但术前一定要选择好子宫肌瘤的大小、类型,排除恶性病变。术中注意手术技巧和良好的监护。
Objective To investigate the curative effect, feasibility and safety of radiofrequency catheter ablation combined with mifepristone in the treatment of uterine fibroids. Methods 90 cases of uterine leiomyoma treated by radiofrequency catheter ablation combined with mifepristone in our hospital from 2008 to 2011 were selected, including 22 cases of submucous myoma, 47 cases of intramural fibroids, 21 cases of subserosal fibroids Cases, single myoma in 51 cases, multiple fibroids in 39 cases, diameter ≥ 2cm, ≤ 8cm, for clinical analysis. Results 3 months after the review: ①58 cases were completely cured (standard: fibroids completely disappeared or fibroids diameter reduction of 80% or more, no clinical symptoms). ② improved in 25 cases (standard: fibroids diameter reduced 50% to 80%, clinical symptoms improved). ③ effective in 6 cases (standard: fibroids diameter reduction of 20% to 50%, clinical symptoms have improved). ④ invalid in 1 case (standard: fibroids diameter reduced by 20% or less, no improvement in clinical symptoms.) Reoperation, fibroids reduced by 50% or more, clinical symptoms improved significantly, the total effective rate of 100%. Conclusion Radiofrequency ablation of self-coagulation knife combined with mifepristone in the treatment of uterine fibroids is safe and feasible, and the curative effect is affirmed. However, we must choose a good preoperative uterine fibroids size, type, rule out malignant lesions. Intraoperative attention to surgical skills and good care.