高强度聚焦超声与腹腔镜子宫肌瘤剔除术治疗子宫肌瘤的对比研究。

High-intensity focused ultrasound and laparoscopic myomectomy in the treatment of uterine fibroids: a comparative study.

机构信息

Department of Obstetrics and Gynecology, the Fifth Affiliated Hospital of Xinjiang Medical University, Xinjiang, China.

出版信息

BJOG. 2017 Aug;124 Suppl 3:36-39. doi: 10.1111/1471-0528.14745.

DOI:10.1111/1471-0528.14745

PMID:28856854

Abstract

OBJECTIVE

To compare the clinical efficacies of high-intensity focused ultrasound (HIFU) and laparoscopic myomectomy (LM) in the treatment of uterine fibroids and their effects on patients' quality of life.

DESIGN

A non-randomised control study.

SETTING

Gynaecological department in a university teaching hospital.

POPULATION

Patients with uterine fibroids.

METHODS

From November 2014 to November 2015, 166 patients with uterine fibroids were enrolled and underwent HIFU (n = 99) and LM (n = 67) surgeries, respectively. Clinical efficacy, postoperative complications and quality of life after treatment were evaluated using the SF-36 Scale to compare the differences in each variable at the 1-year follow up.

MAIN OUTCOMES MEASURES

Differences in efficacy, safety and quality of life between the patients treated with HIFU and LM.

RESULTS

The 12-month follow-up results showed that the HIFU group had a total effective rate of 99%; only one patient underwent alternative treatment due to non-apparent tumour shrinkage. All patients in the LM group showed complete tumour disappearance. Of these patients, 52 showed significant clinical improvement, 15 with partial clinical improvement, a total effective rate of 98%. There was no significant difference in effectivity rate between the two groups (P > 0.05). Both treatments effectively improved patients' quality of life. Compared with the LM group, patients in the HIFU group experienced no blood loss, a shorter hospital stay and fewer adverse effects and complications, the difference being statistically significant (P < 0.05).

CONCLUSIONS

High-intensity focused ultrasound can be as efficacious as LM therapy and effectively improve patients' quality of life in the treatment of uterine fibroids, with fewer adverse effects and complications, shorter hospital stays, and quicker postoperative recovery compared with LM therapy.

TWEETABLE ABSTRACT

Patients with uterine fibroids can be effectively treated with both HIFU and myomectomy.

摘要

目的

比较高强度聚焦超声（HIFU）与腹腔镜子宫肌瘤剔除术（LM）治疗子宫肌瘤的临床疗效及其对患者生活质量的影响。

设计

非随机对照研究。

地点

某大学附属医院妇科。

人群

子宫肌瘤患者。

方法

2014 年 11 月至 2015 年 11 月，166 例子宫肌瘤患者分别接受 HIFU（n=99）和 LM（n=67）治疗。采用 SF-36 量表评估患者的临床疗效、术后并发症及治疗后生活质量，比较两组患者 1 年随访时各项指标的差异。

主要观察指标

HIFU 与 LM 治疗患者的疗效、安全性及生活质量差异。

结果

12 个月的随访结果显示，HIFU 组总有效率为 99%；仅 1 例因肿瘤缩小不明显而改行其他治疗。LM 组患者肿瘤均完全消失，其中 52 例患者临床症状显著改善，15 例患者部分临床症状改善，总有效率为 98%。两组间有效率差异无统计学意义（P＞0.05）。两种治疗方法均有效改善了患者的生活质量。与 LM 组相比，HIFU 组患者术中出血量少、住院时间短、不良反应及并发症少，差异均有统计学意义（P＜0.05）。