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射频消融联合米非司酮与射频消融治疗大型子宫肌瘤的比较。

Comparison between radiofrequency ablation combined with mifepristone and radiofrequency ablation for large uterine fibroids.

机构信息

Department of Ultrasound, Beijing Chaoyang Hospital Capital Medical University, Beijing, PR China.

Department of Gynecology, the PLA Rocket Force General Hospital, Beijing, PR China.

出版信息

Int J Hyperthermia. 2021;38(1):777-780. doi: 10.1080/02656736.2021.1922763.

Abstract

OBJECTIVE

To evaluate the clinical outcomes of transvaginal ultrasound-guided (US-guided) radiofrequency ablation (RFA) combined with mifepristone for the treatment of large uterine fibroids.

METHODS

Between June 2016 and December 2018, a total of 30 patients with symptomatic uterine fibroids (≥5cm) who underwent transvaginal US-guided RFA combined with mifepristone were included in this retrospective study. A matching cohort of 30 patients underwent transvaginal US-guided RFA without mifepristone as controls. The technical efficacy, complications and mid-term treatment effectiveness were assessed and compared with the controls.

RESULTS

The mean volume of uterine fibroid was 168.3 ± 40.1 cm. The mean ablation time was 23.5 ± 11.3 min in the combined treatment group, which was demonstrably less than that of the RFA group, which was 45.7 ± 6.8 min. The mean number of punctures was 2.2 ± 0.6 in the combined treatment group, which was significantly less than that of the RFA group. No major complications occurred. The mean percentages of regression of fibroid at 3 and 12 months after the course of the combined treatment were 73.3% and 90.1%, respectively, which were significantly more than those of the RFA group. Quality of life and symptom scores improved in both groups but to a greater extent in the combined treatment group.

CONCLUSIONS

US-guided RFA combined with mifepristone might be a simple, safe and effective alternative for the treatment of large uterine fibroids.

摘要

目的

评估经阴道超声引导(US 引导)射频消融(RFA)联合米非司酮治疗大型子宫肌瘤的临床疗效。

方法

回顾性分析 2016 年 6 月至 2018 年 12 月期间 30 例因症状性子宫肌瘤(≥5cm)接受经阴道 US 引导 RFA 联合米非司酮治疗的患者。将同期 30 例因症状性子宫肌瘤(≥5cm)接受经阴道 US 引导 RFA 治疗但未使用米非司酮的患者作为对照组。评估和比较两组的技术疗效、并发症和中期治疗效果。

结果

子宫肌瘤平均体积为 168.3±40.1cm。联合治疗组的平均消融时间为 23.5±11.3min,明显短于 RFA 组的 45.7±6.8min。联合治疗组的平均穿刺次数为 2.2±0.6 次,明显少于 RFA 组。无严重并发症发生。联合治疗组在疗程结束后 3 和 12 个月时肌瘤的平均消退率分别为 73.3%和 90.1%,明显高于 RFA 组。两组的生活质量和症状评分均有所改善,但联合治疗组改善更明显。

结论

经阴道超声引导 RFA 联合米非司酮治疗大型子宫肌瘤可能是一种简单、安全、有效的方法。

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