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目的:探讨高强度聚焦超声(high intensity focused ultrasound,HIFU)治疗子宫肌瘤的临床疗效及其安全性。方法:回顾性分析我院2007年1月～2011年1月300例采用高强度聚焦超声治疗的子宫肌瘤患者的临床资料,比较分析治疗前后瘤体大小、病灶内部回声、临床症状改善情况、血流的变化及超声造影图像改变。结果:HIFU治疗后1、3、6及12个月,瘤体体积均较治疗前显著缩小(P<0.05),显效率80.33%(241例),有效率19.33%(58例),无效率0.33%(1例),肌瘤所致的临床症状减轻或消失,瘤体内部回声增强,彩色血流均消失,超声造影瘤体内无灌注。治疗期间,患者出现治疗部位疼痛、骶尾部酸胀及肛门坠胀,治疗结束时症状消失;治疗过程中出现腿部疼痛、麻木症状,经过重新定位后症状消失,少数出现阴道少量流血,给予止血药;治疗后出现血尿,经大量喝水排尿后消失。结论:HIFU治疗子宫肌瘤是安全有效的,在妇科领域便于推广。
Objective: To investigate the clinical efficacy and safety of high intensity focused ultrasound (HIFU) in the treatment of uterine fibroids. Methods: The clinical data of 300 patients with uterine fibroids treated with high-intensity focused ultrasound in our hospital from January 2007 to January 2011 were retrospectively analyzed. The tumor size, lesion internal echo and clinical symptoms before and after treatment were compared and analyzed. Blood flow changes and contrast-enhanced ultrasound images. Results: At 1, 3, 6 and 12 months after HIFU treatment, the tumor volume was significantly reduced (P <0.05), the effective rate was 80.33% (241 cases), the effective rate was 19.33% (58 cases) 0.33% (1 case). The clinical symptoms caused by fibroids were reduced or disappeared. The echo inside the tumor was enhanced and the color blood flow disappeared. There was no perfusion in the CEUS. During the treatment, the patient showed pain in the treatment site, sore sacral swelling and anus bulge, and the symptoms disappeared at the end of the treatment. Leg pain and numbness symptoms were found during the treatment. The symptoms disappeared after repositioning, and a small number of vaginal bleeding occurred. Hemostasis Medicine; hematuria after treatment, after a lot of water urination disappeared. Conclusion: HIFU treatment of uterine fibroids is safe and effective in the field of gynecology to facilitate the promotion.