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介入超声在子宫黏膜下肌瘤诊断与治疗中的应用

Diagnosis and treatment of submucous myoma of the uterus with interventional ultrasound.

作者信息

Liang Bo, Xie Yang-Gui, Xu Xiao-Ping, Hu Chun-Hong

机构信息

Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China.

Department of Ultrasonography, Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, P.R. China.

出版信息

Oncol Lett. 2018 May;15(5):6189-6194. doi: 10.3892/ol.2018.8122. Epub 2018 Feb 27.

Abstract

The value of interventional ultrasound in the diagnosis and treatment of submucous myoma of the uterus was assessed to study the ultrasonographic features of modified sonohysterography for submucous polyp of uterus. A total of 25 patients diagnosed preliminarily as submucous myoma of the uterus via conventional ultrasound examination from June 2014 to December 2016 were enrolled in the study. The diagnosis was made via the comprehensive analysis of ultrasound-guided modified SHG, followed by ultrasound-guided needle biopsy and sclerotherapy of tumor. After modified SHG and ultrasound-guided needle biopsy, 96% (24/25) cases were confirmed pathologically as submucous myoma of the uterus. After treatment, the maximum diameter of myoma in patients with submucous myoma of uterus was significantly different, and the volume of myoma was significantly reduced. After treatment, the clinical symptoms of patients with submucous myoma of the uterus were obviously improved compared to before treatment (P<0.05). It was found in the follow-up after treatment that a small number of patients suffered from mild abdominal pain, increased secretion, slight vaginal bleeding, cold sweat, pale complexion, dizziness and other symptoms, which, however, disappeared after treatment for about 1 week. The score of 36 item Short-Form Health Survey Questionnaire of patients with submucous myoma of the uterus was significantly different before and after treatment (P<0.05). Interventional ultrasonography can effectively diagnose the submucous myoma of uterus. The treatment of submucous myoma of uterus with ultrasound-guided intratumor injection of lauromacrogol is characterized by simple operation, which can effectively reduce the tumor diameter and volume, improve the blood flow in patients, reduce the postoperative adverse reactions and alleviate the patient's pain, so it is a new type of minimally invasive treatment method of submucous myoma of the uterus, and it is worthy of clinical promotion and application.

摘要

评估介入超声在子宫黏膜下肌瘤诊断及治疗中的价值,以研究子宫黏膜下息肉改良超声子宫造影的超声特征。选取2014年6月至2016年12月期间经传统超声检查初步诊断为子宫黏膜下肌瘤的25例患者纳入研究。通过超声引导下改良超声子宫造影综合分析进行诊断,随后行超声引导下肿瘤穿刺活检及硬化治疗。改良超声子宫造影及超声引导下穿刺活检后,96%(24/25)病例经病理确诊为子宫黏膜下肌瘤。治疗后,子宫黏膜下肌瘤患者肌瘤最大径有显著差异,肌瘤体积明显缩小。治疗后,子宫黏膜下肌瘤患者的临床症状较治疗前明显改善(P<0.05)。治疗后随访发现,少数患者出现轻微腹痛、分泌物增多、少量阴道流血、冷汗、面色苍白、头晕等症状,但治疗约1周后症状消失。子宫黏膜下肌瘤患者治疗前后36项简短健康调查问卷评分有显著差异(P<0.05)。介入超声能有效诊断子宫黏膜下肌瘤。超声引导下瘤体内注射聚桂醇治疗子宫黏膜下肌瘤操作简便,可有效缩小肿瘤直径及体积,改善患者血流,减少术后不良反应,减轻患者痛苦,是一种新型的子宫黏膜下肌瘤微创治疗方法,值得临床推广应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86a8/5876458/aff661a0ee52/ol-15-05-6189-g00.jpg

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