Department of Interventional Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China.
Department of Ultrasound, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Int J Hyperthermia. 2020;37(1):151-156. doi: 10.1080/02656736.2019.1708481.
To prospectively compare the effectiveness and safety of percutaneous microwave ablation (PMWA) and ultrasound-guided radiofrequency ablation (USgRFA) for treating symptomatic uterine adenomyosis. One hundred and thirty-three women with symptomatic uterine adenomyosis who met the inclusion criteria were enrolled in our study from October 2015 to October 2017. Sixty-eight patients underwent PMWA, and sixty-five patients underwent USgRFA. All patients were followed up for 12 months. Assessment endpoints included treatment time, percentage ablation, percentage uterine regression, symptom severity scores (SSSs), dysmenorrhea scores and adverse events. The mean age of the patients in our study was 39.4 ± 4.2 years (range, 35-50 years), and the median volume of uterine adenomyosis was 124.3 cm (range, 28.7-374.5 cm). The mean ablation time was 16.3 ± 4.9 min (range, 5-23 min) in the MWA group, which was demonstrably superior to that of the RFA group, which was 37.5 ± 6.2 min (range, 5-39 min). The mean percentages of ablation of uterine adenomyosis were 79.7 ± 15.1% and 79.2 ± 14.2% in the MWA group and the RFA group, respectively, and showed no significant difference between the groups. The percentages of regression of uterine volume also showed no marked difference between the two groups. Changes in the dysmenorrhea scores and the SSSs after ablation were similar in the MWA group and in the RFA group, and no significant difference was found between the groups. Finally, the percentage occurrence of adverse events was the same in the two groups. The safety and effectiveness of PMWA and USgRFA in the treatment of uterine adenomyosis were similar; however, the mean ablation time of PMWA was shorter than that of USgRFA.
前瞻性比较经皮微波消融(PMWA)和超声引导射频消融(USgRFA)治疗症状性子宫腺肌病的有效性和安全性。我们从 2015 年 10 月至 2017 年 10 月期间共招募了 133 名符合纳入标准的症状性子宫腺肌病患者,将其分为 PMWA 组(68 例)和 USgRFA 组(65 例)。所有患者均随访 12 个月。评估终点包括治疗时间、消融百分比、子宫体积缩小百分比、症状严重程度评分(SSS)、痛经评分和不良事件。研究对象的平均年龄为 39.4±4.2 岁(范围:35-50 岁),子宫腺肌病的中位体积为 124.3cm(范围:28.7-374.5cm)。PMWA 组的平均消融时间为 16.3±4.9min(范围:5-23min),明显短于 USgRFA 组的 37.5±6.2min(范围:5-39min)。PMWA 组和 USgRFA 组的子宫腺肌病消融百分比分别为 79.7±15.1%和 79.2±14.2%,组间无显著差异。两组子宫体积缩小百分比也无显著差异。消融后痛经评分和 SSS 的变化在 PMWA 组和 USgRFA 组相似,组间无显著差异。两组不良事件发生率的百分比也相同。PMWA 和 USgRFA 治疗子宫腺肌病的安全性和有效性相似,但 PMWA 的平均消融时间短于 USgRFA。