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射频热消融治疗子宫肌瘤:一项10年回顾性队列研究。

Treatment of uterine myomas by radiofrequency thermal ablation: a 10-year retrospective cohort study.

作者信息

Yin Geping, Chen Ming, Yang Shujun, Li Juan, Zhu Tongyu, Zhao Xiaoli

机构信息

Department of Obstetrics & Gynecology, Jinan Military General Hospital, Jinan, China

Department of Obstetrics & Gynecology, Jinan Military General Hospital, Jinan, China.

出版信息

Reprod Sci. 2015 May;22(5):609-14. doi: 10.1177/1933719114556481. Epub 2014 Oct 29.

Abstract

Patients' selection criteria, effectiveness, and safety of radiofrequency thermal ablation (RFTA) therapy for uterine myomas (UM) were assessed using a 10-year retrospective cohort study. From July 2001 to July 2011, a total of 1216 patients treated for UM were divided into 2 groups. Group A consisted of 476 premenopause patients, average age 36.5 ± 8.5 years, average number of myomas 1.7 ± 0.9, and average diameter of myomas 4.5 ± 1.5 cm, and group B consisted of 740 menopause patients, average age 48.5 ± 3.5 years, average number of myomas 2.6 ± 1.3, and average diameter of myomas 5.0 ± 2.5 cm. Average follow-up period was 36.5 ± 11.5 months. At 1, 3, 6, 12, and 24 months after RFTA, average diameters of myomas in group A were 3.8, 3.0, 2.7, 2.4, and 2.2 cm, respectively, and 47.7% (227 of 476) of patients had tumor trace at 12 months after RFTA. In group B, the results were 4.7, 3.7, 3.3, 2.3, and 2.3 cm, respectively, and 58.8% (435 of 740) of patients had tumor trace at 12 months after RFTA. Three months after treatment, myoma volumes were significantly reduced in both the groups (P < .01), and group B had higher rate of tumor trace at 12 months after RFTA than group A (P < .05). Clinical symptoms and health-related quality-of-life outcome (HRQL) were significantly improved after RFTA in both groups and the postoperative recurrence rate of UM was significantly higher in group A at 10.7% (51 of 476) than group B at 2.4% (18 of 740; P < .05). Radiofrequency thermal ablation is an excellent minimally invasive treatment for UM smaller than 5.0 cm in diameter.

摘要

采用一项为期10年的回顾性队列研究,评估了射频热消融(RFTA)治疗子宫肌瘤(UM)的患者选择标准、有效性和安全性。2001年7月至2011年7月,共有1216例接受UM治疗的患者被分为两组。A组由476例绝经前患者组成,平均年龄36.5±8.5岁,平均肌瘤数量1.7±0.9个,平均肌瘤直径4.5±1.5cm;B组由740例绝经后患者组成,平均年龄48.5±3.5岁,平均肌瘤数量2.6±1.3个,平均肌瘤直径5.0±2.5cm。平均随访期为36.5±11.5个月。RFTA术后1、3、6、12和24个月,A组肌瘤平均直径分别为3.8、3.0、2.7、2.4和2.2cm,47.7%(476例中的227例)患者在RFTA术后12个月有肿瘤残留。B组的结果分别为4.7、3.7、3.3、2.3和2.3cm,58.8%(740例中的435例)患者在RFTA术后12个月有肿瘤残留。治疗后3个月,两组肌瘤体积均显著减小(P<.01),B组在RFTA术后12个月的肿瘤残留率高于A组(P<.05)。两组患者RFTA术后临床症状和健康相关生活质量结局(HRQL)均显著改善,A组UM术后复发率显著高于B组,分别为10.7%(476例中的51例)和2.4%(740例中的18例;P<.05)。射频热消融是治疗直径小于5.0cm的UM的一种优秀的微创治疗方法。

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