Objective: To observe the clinical efficacy of high intensity focused ultrasound(HIFU) in treating uterine fibroids and its effects on patients' ovarian and immune functions.Methods: 132 patients with uterine fibroids were divided into HIFU group(60 cases),myomectomy group(39 cases) and hysterectomy group(33 cases) according to different surgical procedures. The hemoglobin concentrations, menstrual cycle, endometrial thickness, ovarian and immune function before operation and 6 months after operation were measured.Results: Compared with the preoperative results, the hemoglobin concentrations in each group were increased significantly at 6 months after operation, menstrual cycle of HIFU group and myomectomy group were shortened significantly, endometriumofmyomectomy group was thinner significantly(P<0.05), endometriumof HIFU group was significantly thicker than that of myomectomy group(P<0.05), the follicle-stimulating hormone(FSH) and luteinizing hormone(LH) at 6 months after operation in hysterectomy group were significantly higher and estradiol(E2) was significantly lower, FSH and LH in hysterectomy group were significantly different from those in HIFU group and fibroid-elimination group(P<0.05).At 6 months after operation, the immune function indicators in HIFU group were significantly higher than that in myomectomy group and hysterectomy group(P<0.05). Conclusion: HIFU has no significant effect on ovarian and immune function in patients with uterine fibroids, and HIFU can be used as the preferred treatment for uterine fibroids under the premise of the surgical indications. |
[1] 子宫肌瘤的诊治中国专家共识专家组.子宫肌瘤的诊治中国专家共识[J].中华妇产科杂志,2017,8(12):793-800.
[2] 董晓秋,王璐璐,邵小慧,等.子宫肌瘤射频消融治疗新进展及应用前景[J/OL].中华医学超声杂志(电子版),2017,14(2):91-94.
[3] 李守忠,戴绿叶,贺克平,等.超声消融治疗对不同部位子宫肌瘤消融率及瘤体大小的影响[J].现代医学,2017,45(3):344-348.
[4] 张雯珂,武周炜.高强度聚焦超声在妇产科领域的应用进展[J].医疗卫生装备,2013,34(5):90-92.
[5] BULUN S E.Uterine fibroids[J].N Engl J Med,2013,369(14):1344-1355.
[6] SEON S G,SIHYUM C,MAN K Y,et al.Current medical treatment of uterine fibroids[J].Obstet Gynecol Sci,2018,61(2):192-201.
[7] ZHANG L,ZHANG W,ORSI F,et al.Ultrasound-guided high intensity focused ultrasound for the treatment of gynaecological diseases:a review of safety and eficacy[J].Int J Hyperthermia,2015,31(3):280-284.
[8] 曹心宇,徐海燕.高强度聚焦超声治疗原发性肝癌的临床效果分析[J].东南大学学报(医学版),2018,37(6):1054-1057.
[9] 邹敏,熊郁,汪炼,等.多发子宫肌瘤高强度聚焦超声治疗与生育[J].中国实用妇科与产科杂志,2016,32(2):132-135.
[10] 金琳,石琴,封岚,等.CEUS定量参数及增强形态与高强度聚焦超声治疗子宫肌瘤疗效的关系[J].中国介入影像及治疗学,2018,15(3):152-155.
[11] QIN J,CHEN J Y,ZHAO W P,et al.Outcome of unintended regnancy after ultrasound-guided high-intensity focused ultrasound ablation of uterine fibroids[J].Int J Gynaecol Obstet,2012,117(3):273-277.
[12] MOORMAN P G,MYERS E R,SCHILDKRAUT J M,et al.Effect of hysterectomy with ovarian preseravtion on ovarian function[J].Obstet Gynecol,2011,118(6):1271-1279.
[13] 陈衡,黄耀,张卫星,等.高强度聚焦超声治疗子宫肌瘤对卵巢功能的影响[J/OL].中华妇幼临床医学杂志(电子版),2012,8(4):468-470.
[14] WANG X,QIN J,CHEN J,et al.The efect of high-intensity focused ultrasound treatment on immune function in patients with uterine fibroids[J].Int J Hyperthermia,2013,29(3):225-233.
[15] BIJGAART R J E V D,EIKELENBOOM D C,HOOGENBOOM M,et al.Thermal and mechanical high-intensity focused ultrasound:perspectives on tumor ablation,immune effects and combination strategies[J].Cancer Immunol Immunother,2017,66(2):247-258. |