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高强度聚焦超声消融治疗无生育需求的黏膜下子宫肌瘤患者的安全性和有效性:一项单中心真实世界数据回顾性研究

Safety and Efficacy of High-intensity Focused Ultrasound Ablation for Patients with Submucosal Fibroids without Fertility Needs: A Single-center Real-world Data Retrospective Study.

作者信息

Shao Xue, Huang Guohua, Liu Yanglu, Zhang Hao, Luo Shuang, Liu Rui

机构信息

School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, China.

Department of Gynecology, Suining Central Hospital, Suining, China.

出版信息

Gynecol Minim Invasive Ther. 2025 May 22;14(2):137-144. doi: 10.4103/gmit.GMIT-D-24-00045. eCollection 2025 Apr-Jun.

DOI:10.4103/gmit.GMIT-D-24-00045
PMID:40521576
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12165683/
Abstract

OBJECTIVES

To analyze clinical outcomes and the factors that influence the therapeutic outcomes of high-intensity focused ultrasound (HIFU) ablation for different types of submucosal uterine fibroids.

MATERIALS AND METHODS

A total of 626 patients without fertility requirements who underwent HIFU ablation for submucosal uterine fibroids at Suining Central Hospital from November 1, 2010, to December 31, 2023, were retrospectively reviewed. The safety and clinical efficacy of HIFU ablation therapy for submucosal uterine fibroids were evaluated.

RESULTS

The patients with submucosal uterine fibroids presented increased menstrual volume in 25.24% (158/626) of patients, prolonged menstrual period in 16.93% (106/626) of patients, lower abdominal pain in 5.59% (35/626) of patients, and anemia in 39.46% (247/626) of patients in this study. The average nonperfused volume ratio of type 0, type I, and type II submucosal uterine fibroids was 89.00%, 88.54%, and 85.33%, respectively. No severe adverse events occurred in any of the patients during or after HIFU treatment. Twenty-five patients received reintervention treatment (HIFU or surgical fibroid resection) in 6 months to 7.28 years after HIFU. A significant difference was observed in postoperative combined treatment between the reintervention and non-reintervention group ( < 0.05).

CONCLUSION

HIFU ablation for type 0, type I, and type II submucosal uterine fibroids is safe and effective. The combination management mode after HIFU could reduce the chance of reintervention treatment.

摘要

目的

分析高强度聚焦超声(HIFU)消融治疗不同类型黏膜下子宫肌瘤的临床疗效及影响治疗效果的因素。

材料与方法

回顾性分析2010年11月1日至2023年12月31日在遂宁市中心医院接受HIFU消融治疗黏膜下子宫肌瘤的626例无生育要求的患者。评估HIFU消融治疗黏膜下子宫肌瘤的安全性和临床疗效。

结果

本研究中,黏膜下子宫肌瘤患者出现月经量增多的占25.24%(158/626),经期延长的占16.93%(106/626),下腹痛的占5.59%(35/626),贫血的占39.46%(247/626)。0型、Ⅰ型和Ⅱ型黏膜下子宫肌瘤的平均无灌注体积比分别为89.00%、88.54%和85.33%。HIFU治疗期间及治疗后,所有患者均未发生严重不良事件。25例患者在HIFU治疗后6个月至7.28年接受了再次干预治疗(HIFU或手术切除肌瘤)。再次干预组与未再次干预组术后联合治疗情况存在显著差异(<0.05)。

结论

HIFU消融治疗0型、Ⅰ型和Ⅱ型黏膜下子宫肌瘤安全有效。HIFU术后的联合管理模式可减少再次干预治疗的机会。

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本文引用的文献

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Int J Hyperthermia. 2024;41(1):2299479. doi: 10.1080/02656736.2023.2299479. Epub 2024 Jan 2.
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Evaluation of the timing and safety of hysteroscopic myomectomy of large submucosal fibroids pretreated by high intensity focused ultrasound.高强度聚焦超声预处理的大型黏膜下子宫肌瘤宫腔镜切除术时机和安全性评估。
Int J Hyperthermia. 2023;40(1):2249275. doi: 10.1080/02656736.2023.2249275.
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An Alternative Treatment for Uterine Fibroids and Adenomyosis: High-intensity Focused Ultrasound.子宫肌瘤和子宫腺肌病的一种替代治疗方法:高强度聚焦超声
Gynecol Minim Invasive Ther. 2023 May 18;12(2):61-63. doi: 10.4103/gmit.gmit_20_23. eCollection 2023 Apr-Jun.
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Prediction of postoperative reintervention risk for uterine fibroids using clinical-imaging features and T2WI radiomics before high-intensity focused ultrasound ablation.基于高强度聚焦超声消融术前临床-影像特征和 T2WI 影像组学预测子宫肌瘤的术后再干预风险。
Int J Hyperthermia. 2023;40(1):2226847. doi: 10.1080/02656736.2023.2226847.
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Oral Gonadotropin-Releasing Hormone Antagonist Relugolix Has the Same Effect as Gonadotropin-Releasing Hormone Agonist Injections in Terms of Preparation for Transcervical Resection Myomectomy.口服促性腺激素释放激素拮抗剂relugolix在为经宫颈肌瘤切除术做准备方面与促性腺激素释放激素激动剂注射具有相同效果。
Gynecol Minim Invasive Ther. 2022 Nov 7;11(4):238-241. doi: 10.4103/gmit.gmit_9_22. eCollection 2022 Oct-Dec.
6
Characteristics of Submucous Myomas and the Risk of Anemia.黏膜下肌瘤的特征与贫血风险。
Medicina (Kaunas). 2022 Nov 15;58(11):1652. doi: 10.3390/medicina58111652.
7
Endometrial preservation during resection of type II and type III submucosal fibroids.II型和III型黏膜下肌瘤切除术中的子宫内膜保留
Facts Views Vis Obgyn. 2022 Sep;14(3):283-285. doi: 10.52054/FVVO.14.3.038.
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Int J Hyperthermia. 2021;38(1):1609-1616. doi: 10.1080/02656736.2021.1995053.