Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China and the Department of Interventional Ultrasound, General Hospital of Chinese PLA, Beijing, China (Drs Yang, Ma, and Xu).
Department of Ultrasound, First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China (Dr Hao); Department of Interventional Ultrasound, General Hospital of Chinese PLA, Beijing, China (Dr Hao).
J Minim Invasive Gynecol. 2019 Mar-Apr;26(3):544-550. doi: 10.1016/j.jmig.2018.06.014. Epub 2018 Jun 28.
To prospectively evaluate the clinical effectiveness and safety of ultrasound-guided percutaneous microwave ablation for symptomatic subserosal uterine myomas.
Prospective observational study (Canadian Task Force classification II-1).
A teaching hospital (Department of Interventional Ultrasound, General Hospital of Chinese PLA, Beijing, China).
Sixty-nine patients with symptomatic subserosal uterine myomas treated with ultrasound-guided percutaneous microwave ablation.
All 69 patients underwent ultrasound-guided percutaneous microwave ablation. The number of patients lost to follow-up at was 21 at 3 months, 34 at 6 months, and 35 at 12 months.
The efficacy of treatment was evaluated based the mean myoma volume shrinkage rate and changes in Uterine Fibroid Symptom and Quality of Life Questionnaire scores at 3, 6, and 12 months after therapy. Treatment safety was evaluated based on the Society of Interventional Radiology practice guidelines. The mean patient age was 40.3 ± 4.9 years (range, 26-49 years). The mean myoma volume was 221.74 ± 153.18 cm before ablation, decreasing to 87.24 ± 45.93 cm at 3 months after ablation (p < .001), 46.68 ± 24.7 cm at 6 months after ablation (p < .001), and 38.05 ± 24.93 cm at 12 months after ablation (p <.001), respectively. Between pretreatment and 3-month follow-up, the mean symptom severity score decreased from 34.53 ± 3.83 to 12.74 ± 3.07 (p < .001), and the mean health-related quality of life score increased from 45.25 ± 10.97 to 78.48 ± 11.39 (p < .001). Both scores remained stable at the 6- and 12-month follow-up time points. No permanent injury or fatal complications were seen in this series.
Ultrasound-guided percutaneous microwave ablation of subserosal uterine myomas is a promising treatment method. Further studies with larger sample sizes and a control group are needed.
前瞻性评估超声引导经皮微波消融治疗有症状的浆膜下子宫肌瘤的临床疗效和安全性。
前瞻性观察研究（加拿大任务组分类 II-1）。
一家教学医院（中国人民解放军总医院介入超声科，北京）。
69 例接受超声引导经皮微波消融治疗的有症状浆膜下子宫肌瘤患者。
所有 69 例患者均行超声引导经皮微波消融治疗。3 个月时失访 21 例，6 个月时失访 34 例，12 个月时失访 35 例。
根据治疗后 3、6 和 12 个月的平均肌瘤体积缩小率和子宫纤维瘤症状和生活质量问卷评分的变化评估治疗效果。根据介入放射学会实践指南评估治疗安全性。患者年龄平均为 40.3±4.9 岁（26-49 岁）。消融前平均肌瘤体积为 221.74±153.18cm，消融后 3 个月缩小至 87.24±45.93cm（p＜0.001），消融后 6 个月缩小至 46.68±24.7cm（p＜0.001），消融后 12 个月缩小至 38.05±24.93cm（p＜0.001）。与术前 3 个月随访相比，平均症状严重程度评分从 34.53±3.83 降至 12.74±3.07（p＜0.001），健康相关生活质量评分从 45.25±10.97 升至 78.48±11.39（p＜0.001）。在 6 个月和 12 个月的随访时间点，这两个评分均保持稳定。本研究系列中未出现永久性损伤或致命并发症。
超声引导经皮微波消融治疗浆膜下子宫肌瘤是一种有前途的治疗方法。需要进一步开展更大样本量和对照组的研究。
