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超声引导下经皮射频热消融治疗有症状的子宫肌瘤-单中心 52 周随访结果。

Ultrasound guided percutaneous radiofrequency thermal ablation of symptomatic uterine fibroids - results from a single center and 52 weeks of follow up.

机构信息

Ankara City Hospital, Ankara City Hospital, Interventional Radiology Department, 06800 Ankara, Turkey.

出版信息

Ginekol Pol. 2020;91(8):447-452. doi: 10.5603/GP.2020.0074.

Abstract

OBJECTIVES

Uterine fibroids are one of the most common female disorder of the reproductive age and may cause abnormal uterine bleeding (UAB), pain or infertility. Our aim was to evaluate the safety and efficacy of percutaneous radio frequency ablation (RFA) in reducing clinical symptoms, fibroid volume and improving laboratory parameters.

MATERIAL AND METHODS

Thirty-five symptomatic patients with 54 uterine fibroids were enrolled. Preintervention evaluation was made for each participant and included ultrasonography to assess the volume, largest diameter and location of the fibroid and Visual Analogue Scale (VAS) for quantifying the degree of menstrual pain. The magnitude of menstrual bleeding was scored for each patient by using pictogram. Preprocedural laboratory assessment included hemoglobulin and hematocrit. Treatment efficacy was evaluated at 3, 6 and 12 months after the intervention with ultrasound (US) measurements, symptom scores and laboratory parameters.

RESULTS

Pretreatment mean Hb was significantly lower than those at 3, 6 and 12 month post treatment visits (p < 0.001). The pretreatment median volume was significantly higher than the median volumes measured at 3, 6 and 12 months after RFA (p < 0.001). Visual Analogue Score (VAS) for pain was significantly lower than baseline values at 6 and 12 month visits (p < 0.01). Pretreatment bleeding scores and the number of patients in the predefined severe bleeding category were significantly decreased.

CONCLUSIONS

US guided RF ablation of uterine fibroids is relatively safe and effective procedure. It can be applied to the fibroids with varying localizations and sizes. It reduces the fibroid volume and obviate a need for more invasive treatment.

摘要

目的

子宫肌瘤是育龄期女性最常见的疾病之一,可能导致异常子宫出血(UAB)、疼痛或不孕。我们的目的是评估经皮射频消融(RFA)在减少临床症状、肌瘤体积和改善实验室参数方面的安全性和有效性。

材料和方法

35 名患有 54 个子宫肌瘤的有症状患者被纳入研究。对每位参与者进行干预前评估,包括超声检查以评估肌瘤的体积、最大直径和位置,以及视觉模拟量表(VAS)以量化月经疼痛程度。每位患者的月经出血程度通过图像法进行评分。术前实验室评估包括血红蛋白和血细胞比容。治疗后 3、6 和 12 个月通过超声(US)测量、症状评分和实验室参数评估治疗效果。

结果

治疗前血红蛋白明显低于治疗后 3、6 和 12 个月(p < 0.001)。治疗前中位数体积明显高于 RFA 后 3、6 和 12 个月测量的中位数体积(p < 0.001)。疼痛的视觉模拟评分(VAS)在 6 和 12 个月时明显低于基线值(p < 0.01)。治疗前出血评分和处于预定严重出血类别的患者数量明显减少。

结论

US 引导的子宫肌瘤 RFA 是一种相对安全有效的方法。它可以应用于不同部位和大小的肌瘤。它可以减少肌瘤体积,避免更具侵入性的治疗。

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