Department of Anesthesiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China.
Int J Hyperthermia. 2024;41(1):2338542. doi: 10.1080/02656736.2024.2338542. Epub 2024 Apr 29.
To investigate the changes in liver and kidney function, red blood cell (RBC) count and hemoglobin (HGB) levels in patients undergoing ultrasound-guided percutaneous microwave ablation (UPMWA) for uterine fibroids on postoperative day 1.
The changes in liver and kidney function, RBC count and HGB levels in 181 patients who underwent selective UPMWA in the Second Affiliated Hospital of Shantou University Medical College, China, between August 2017 and January 2023 were retrospectively analyzed.
All patients underwent UPMWA for uterine fibroids; 179 patients had multiple uterine fibroids and 2 patients had single uterine fibroids. The maximum fibroid diameter ranged from 18 to 140 mm, with an average of 68.3 mm. Ultrasound imaging was used to confirm that the blood flow signal within the mass had disappeared in all patients, indicating that the ablation was effective. Within 24 h, compared with before UPMWA, levels of total bilirubin, direct bilirubin, indirect bilirubin and aspartate aminotransferase had significantly increased ( < 0.01), whereas levels of total protein, albumin, globulin, alanine aminotransferase, creatinine and urea had significantly decreased ( < 0.01). Acute kidney injury (AKI) occurred in 1 of the 181 patients. The RBC count and HGB levels decreased significantly after UPMWA ( < 0.01).
Ultrasound-guided percutaneous microwave ablation for uterine fibroids can impose a higher detoxification load on the liver and cause thermal damage to and the destruction of RBCs within local circulation, potentially leading to AKI. Protein levels significantly decreased after UPMWA. Therefore, perioperative organ function protection measures and treatment should be actively integrated into clinical practice to improve prognosis and enhance recovery.
探讨经皮超声引导微波消融(UPMWA)治疗子宫肌瘤患者术后第 1 天肝肾功能、红细胞(RBC)计数和血红蛋白(HGB)水平的变化。
回顾性分析 2017 年 8 月至 2023 年 1 月在汕头大学医学院第二附属医院行选择性 UPMWA 的 181 例患者的肝肾功能、RBC 计数和 HGB 水平变化。
所有患者均因子宫肌瘤行 UPMWA 治疗;179 例患者有多发性子宫肌瘤,2 例患者为单发子宫肌瘤。最大肌瘤直径 18~140mm,平均 68.3mm。超声影像学确认所有患者肿块内血流信号消失,提示消融有效。24h 内,与 UPMWA 前相比,总胆红素、直接胆红素、间接胆红素和天冬氨酸转氨酶水平明显升高( < 0.01),而总蛋白、白蛋白、球蛋白、丙氨酸转氨酶、肌酐和尿素水平明显降低( < 0.01)。181 例患者中 1 例发生急性肾损伤(AKI)。UPMWA 后 RBC 计数和 HGB 水平明显下降( < 0.01)。
经皮超声引导微波消融治疗子宫肌瘤会增加肝脏的解毒负荷,并导致局部循环中 RBC 热损伤和破坏,可能导致 AKI。UPMWA 后蛋白水平显著降低。因此,应积极将围手术期器官功能保护措施和治疗纳入临床实践,以改善预后和促进恢复。