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高强度聚焦超声治疗腹壁子宫内膜异位症的疗效及影响因素分析:病例系列研究。

Efficacy and influencing factor analysis of high-intensity focused ultrasound therapy for abdominal wall endometriosis: a case series.

机构信息

Department of Obstetrics and Gynecology, Third Xiangya Hospital of Central South University, Changsha, China.

出版信息

Int J Hyperthermia. 2024;41(1):2320416. doi: 10.1080/02656736.2024.2320416. Epub 2024 Feb 27.

Abstract

OBJECTIVE

The aim of this retrospective study was to investigate the short-term and long-term efficacy of high-intensity focused ultrasound (HIFU) therapy for abdominal wall endometriosis (AWE) and explore its potential influencing factors.

MATERIALS AND METHODS

A total of 80 patients with AWE who underwent HIFU therapy were retrospectively analyzed. Follow-ups were also conducted to evaluate the changes in lesion size and pain relief. Multivariate logistic regression analysis was applied to investigate factors influencing HIFU therapy for AWE.

RESULTS

Among the 80 patients with AWE who received HIFU therapy, the effective rates were 76.3%, 80.5%, and 90.5% after 3, 12 and 24 months of follow-up, respectively. Multivariate logistic regression analysis revealed that the AWE lesion diameter and sonication intensity had statistically significant effects on the 3-month and 12-month efficacy of HIFU therapy for AWE, while age, BMI, disease duration, average sonication power and grey-scale changes did not have statistically significant effects. Four patients with AWE experienced recurrence after HIFU therapy, for a three-year cumulative recurrence rate of 6.3%. Furthermore, ten patients required reintervention after treatment, for a five-year cumulative reintervention rate of 13.9%.

CONCLUSIONS

This study further confirmed the safety and effectiveness of HIFU therapy for AWE. Factors such as AWE lesion diameter and sonication intensity have been identified as key influencers affecting the short-term and long-term efficacy of HIFU therapy for AWE. The first two years following HIFU therapy constitute crucial periods for observation, and judiciously extending follow-up intervals during this timeframe is advised.

摘要

目的

本回顾性研究旨在探讨高强度聚焦超声(HIFU)治疗腹壁子宫内膜异位症(AWE)的短期和长期疗效,并探讨其潜在的影响因素。

材料与方法

回顾性分析 80 例 AWE 患者接受 HIFU 治疗的资料。通过随访评估病变大小和疼痛缓解的变化。采用多因素 logistic 回归分析探讨影响 HIFU 治疗 AWE 的因素。

结果

80 例 AWE 患者接受 HIFU 治疗后,3、12、24 个月的有效率分别为 76.3%、80.5%和 90.5%。多因素 logistic 回归分析显示,AWE 病变直径和超声强度对 HIFU 治疗 AWE 的 3 个月和 12 个月疗效有统计学意义,而年龄、BMI、病程、平均超声功率和灰度变化无统计学意义。4 例 AWE 患者 HIFU 治疗后复发,3 年累积复发率为 6.3%。此外,10 例患者治疗后需要再次干预,5 年累积再干预率为 13.9%。

结论

本研究进一步证实了 HIFU 治疗 AWE 的安全性和有效性。AWE 病变直径和超声强度等因素是影响 HIFU 治疗 AWE 短期和长期疗效的关键因素。HIFU 治疗后前两年是观察的关键时期,建议在此期间谨慎延长随访间隔。

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