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目的探讨无水乙醇肌瘤内注射能否增加高强度聚焦超声(HIFU)靶区能量沉积,缩短治疗时间,提高治疗效率,降低患者疼痛和并发症的发生。方法 80例子宫肌瘤患者随机分成HIFU组(H组)和无水乙醇联合HIFU治疗组(E+H组),E+H组于HIFU治疗前1 h行超声引导下无水乙醇肌瘤内注射,比较两组HIFU消融辐照时间、辐照剂量、能效因子(EEF:消融单位体积所需辐照能量),灰度变化以及两组患者治疗疼痛评分和不良反应。结果 E+H组HIFU辐照时间、辐照剂量、能效因子明显低于H组(P<0.05),E+H组以团块状强回声为主,H组以非团块状强回声为主,治疗疼痛评分及不良反应发生率也高于E+H组。结论无水乙醇肌瘤内注射能够增强HIFU能量在子宫肌瘤内部的沉积,提高HIFU治疗效率,缩短治疗时间,减少治疗剂量,减轻患者疼痛及并发症的发生。
Objective To investigate whether intrathecal injection of ethanol can increase the energy deposition in the target of high intensity focused ultrasound (HIFU), shorten the treatment time, improve the therapeutic efficiency and reduce the occurrence of pain and complications in patients. Methods Eighty patients with uterine fibroids were randomly divided into HIFU group (H group) and absolute alcohol combined with HIFU group (E + H group). E + H group The duration of HIFU ablation, irradiation dose, energy efficiency factor (EEF), the energy needed to ablate unit volume, gray scale changes and pain scores and adverse reactions of two groups were compared between the two groups. Results The irradiation duration, irradiation dose and energy efficiency factor of HIFU in E + H group were significantly lower than those in H group (P <0.05). E + H group was dominated by massive echo, and H group with non-massive echo Lord, the treatment of pain scores and the incidence of adverse reactions are also higher than the E + H group. Conclusion Intrathecal injection of ethanol can enhance the deposition of HIFU energy in uterine fibroids, increase the efficiency of HIFU treatment, shorten the treatment time, reduce the dosage and reduce the pain and complications of patients.