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超声引导经皮微波消融治疗症状性子宫肌瘤的临床研究。

Ultrasound-guided percutaneous microwave ablation for symptomatic uterine fibroid treatment--a clinical study.

机构信息

Ultrasound Department, First Affiliated Hospital of Chinese PLA General Hospital, Beijing, China.

出版信息

Int J Hyperthermia. 2011;27(5):510-6. doi: 10.3109/02656736.2011.562872.

Abstract

OBJECTIVE

The aim of this study was to assess the feasibility, safety and therapeutic effects of ultrasound (US)-guided percutaneous microwave thermal ablation (PMTA) in situ for the treatment of symptomatic uterine fibroid.

MATERIALS AND METHODS

The microwave (MW) antenna was percutaneously inserted into the fibroid under US guidance to perform the ablation. The ultrasound images, any complications and side effects were assessed during and after ablation. The shrinkage rate of the fibroid was calculated after the treatment.

RESULTS

Forty patients underwent the treatment. The baseline fibroid volume was 14.6 to 341.1 cm(3) (mean 140.1 ± 87.4 cm(3)). When the MW therapy started, a heightened echo around the MW emission aperture of the antenna was observed and gradually propagated throughout the fibroid while the ablation continued. The mean ablation time was 490 s. Contrast enhanced MRI showed no enhancement in the fibroid post-ablation. The shrinkage rate of the fibroid was 61.8%, 78.7%, 73.2% and 93.1% at 3, 6, 9, and 12 months after ablation, respectively. Six patients felt pain in their lower abdomens or waists within 12 hours post-ablation, and the discomfort rapidly disappeared. Seven patients had a small amount of vaginal bloody secretions within one to two weeks after treatment, and six of these patients recovered from the bleeding without any therapy after one week. No patient developed complications and fever during or after the ablation.

CONCLUSIONS

PMTA for fibroid is feasible and safe, and it is an easy and fast procedure that is minimally invasive.

摘要

目的

本研究旨在评估超声(US)引导下经皮微波热消融(PMTA)原位治疗有症状子宫肌瘤的可行性、安全性和治疗效果。

材料与方法

在 US 引导下将微波(MW)天线经皮插入肌瘤内进行消融。在消融过程中和之后评估超声图像、任何并发症和副作用。治疗后计算肌瘤的缩小率。

结果

40 名患者接受了治疗。基线肌瘤体积为 14.6 至 341.1cm³(平均 140.1±87.4cm³)。当 MW 治疗开始时,观察到 MW 发射天线周围的回声增强,并随着消融的继续逐渐传播到整个肌瘤中。平均消融时间为 490s。增强 MRI 显示消融后肌瘤无增强。消融后 3、6、9 和 12 个月,肌瘤的缩小率分别为 61.8%、78.7%、73.2%和 93.1%。6 名患者在消融后 12 小时内感到下腹部或腰部疼痛,不适迅速消失。7 名患者在治疗后 1 至 2 周内有少量阴道血性分泌物,其中 6 名患者在一周后无需任何治疗即可从出血中恢复。没有患者在消融过程中和之后出现并发症和发热。

结论

PMTA 治疗子宫肌瘤是可行和安全的,是一种简单、快速、微创的方法。

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