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与单纯高强度聚焦超声(HIFU)或子宫动脉栓塞相比,增强型催产素非镇静 HIFU 治疗子宫肌瘤具有较好的疗效。

Oxytocin-Augmented and Non-Sedating High-Intensity-Focused Ultrasound (HIFU) for Uterine Fibroids Showed Promising Outcome As Compared To HIFU Alone or Uterine Artery Embolization.

机构信息

Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong SAR; Vascular and Interventional Radiology Clinical Science Center, The Chinese University of Hong Kong, Hong Kong SAR.

Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong SAR.

出版信息

Ultrasound Med Biol. 2019 Dec;45(12):3207-3213. doi: 10.1016/j.ultrasmedbio.2019.07.410. Epub 2019 Sep 4.

Abstract

The use of a modified energy transmission protocol and oxytocin augmentation is being proposed as a high-intensity-focused ultrasound (HIFU) treatment for uterine fibroids, to aim for an effective and well-tolerable treatment to be given as an out-patient procedure without anesthesia or sedation. The objective of this study was to evaluate the safety and treatment effectiveness of this new protocol. The treatment outcomes of 9 consecutive patients (study group) were compared with those of 51 patients (control group) who had been randomized (1:1) to receive HIFU (n = 24) or uterine artery embolization ([UAE] n = 27). There was no major adverse event. At 3 mo, the median proportion of fibroid volume compared with the baseline was 51.1% in the study group, significantly smaller than that in the control groups (HIFU 76.6%, UAE 66.2%). At 6 mo, all patients in the study group became symptom free (9/9, 100%), a result significantly better than that of both control groups. The proportion of patients with good quality of life was significantly higher in the study group (5/7, 71.4%) compared with the control groups (HIFU 3/24, 12.5%; UAE 7/27, 25.9%). Within 24 mo, none of the patients in the study HIFU group required re-intervention, a result significantly better than that in the control HIFU group (15/24, 62.5%). The treatment could result in a very promising long-term imaging and clinical outcome that may be better than those of UAE; however, a randomized control trial of larger scale is required for further evaluation of this treatment.

摘要

本研究旨在评估该新方案的安全性和治疗效果。将 9 例连续患者(研究组)的治疗结果与随机(1:1)分为高强度聚焦超声(HIFU)组(n=24)和子宫动脉栓塞术(UAE)组(n=27)的 51 例患者(对照组)的治疗结果进行比较。无重大不良事件。3 个月时,研究组与基线相比,肌瘤体积的中位数比例为 51.1%,明显小于对照组(HIFU 组 76.6%,UAE 组 66.2%)。6 个月时,研究组所有患者均无症状(9/9,100%),明显优于两组对照组。研究组生活质量良好的患者比例(5/7,71.4%)明显高于对照组(HIFU 组 3/24,12.5%;UAE 组 7/27,25.9%)。在 24 个月内,研究组 HIFU 组无一例需要再次介入治疗,明显优于对照组 HIFU 组(15/24,62.5%)。这种治疗可能会产生非常有前途的长期影像学和临床效果,可能优于 UAE;然而,需要更大规模的随机对照试验来进一步评估这种治疗。

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