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超声引导经皮微波消融治疗富血供子宫肌瘤中催产素的应用:初步报告。

Application of oxytocin in ultrasound-guided percutaneous microwave ablation for treatment of hypervascular uterine fibroids: a preliminary report.

机构信息

Department of Ultrasonography, Qianfoshan Hospital Affiliated to Shandong First Medical University , Jinan , China.

Department of Oncology, Liaocheng Tumor Hospital , Liaocheng , China.

出版信息

Int J Hyperthermia. 2019;36(1):761-767. doi: 10.1080/02656736.2019.1639832.

Abstract

This study evaluated the effect of oxytocin administration prior to microwave ablation (MWA) of hypervascular uterine fibroids. Thirty-two patients with 38 hypervascular uterine fibroids (Adler blood flow grade 3) were equally apportioned to receive intravenous oxytocin infusion (0.32 U/min) 20 min before ultrasound-guided percutaneous MWA, or no oxytocin (control). Changes in Adler blood supply grade and myoma volume were observed via color Doppler ultrasonography (CDU). All patients underwent quantitative ablation with single or double needle and microwave power 50 W (180 s). Treatment continued for those who did not reach the therapeutic goal. The myoma necrotic volume was evaluated by contrast-enhanced ultrasound. Ablation rate was the percent of MRI nonenhanced myoma volume after treatment, relative to myoma volume before treatment, 2 days after surgery. Twenty minutes after oxytocin administration, CDU showed significant decrease of blood vessels in myomas, and Adler blood supply decreased from grade 3 to grade 1 or grade 0 in 10 and 9 myomas, respectively. Myoma volumes were reduced by 2.12 ± 0.24%. Necrotic volumes in the oxytocin (control) groups were 36.96 ± 2.78 cm (22.68 ± 3.38 cm) and ablation rates were 95.4 ± 2.7% (85.7 ± 3.3%;  = 12.68, 8.866,  = 0.001, both). No serious complication was noted. Intravenous oxytocin administered before percutaneous MWA of hypervascular uterine fibroids can effectively block the blood supply vessels of the myoma, reduce the heat sink effect, and thereby increase the ablation volume and improve the local therapeutic effect.

摘要

本研究评估了在微波消融(MWA)前给予催产素对富血管性子宫肌瘤的影响。32 名患有 38 个富血管性子宫肌瘤(Adler 血流分级 3)的患者被平均分为两组,分别在超声引导下经皮 MWA 前 20 分钟接受静脉催产素输注(0.32U/min)或不给予催产素(对照组)。通过彩色多普勒超声(CDU)观察 Adler 血供分级和肌瘤体积的变化。所有患者均采用单针或双针进行定量消融,微波功率为 50W(180s)。对于未达到治疗目标的患者,继续治疗。通过对比增强超声评估肌瘤的坏死体积。消融率为治疗后 MRI 无增强肌瘤体积相对于治疗前肌瘤体积的百分比,术后 2 天。催产素给药 20 分钟后,CDU 显示肌瘤内血管明显减少,Adler 血流供应分别从 3 级降至 1 级或 0 级,10 个和 9 个肌瘤分别降低。肌瘤体积减少了 2.12±0.24%。催产素(对照组)组的坏死体积分别为 36.96±2.78cm 和 22.68±3.38cm,消融率分别为 95.4±2.7%和 85.7±3.3%(=12.68,8.866,=0.001,均)。未观察到严重并发症。在富血管性子宫肌瘤经皮 MWA 前静脉给予催产素可有效阻断肌瘤的供血血管,减少热沉效应,从而增加消融体积,提高局部治疗效果。

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