本文選題：子宮腫瘤　切入點：腺肌瘤　出處：《中國醫(yī)學(xué)影像學(xué)雜志》2017年08期 　論文類型：期刊論文

【摘要】：目的探討經(jīng)陰道超聲引導(dǎo)腹腔鏡下經(jīng)皮微波消融治療子宮腺肌瘤的近期療效及臨床應(yīng)用價值。資料與方法選取2015年10月—2016年10月于武漢市中心醫(yī)院就診的痛經(jīng)程度較重、保守治療無效但不愿切除子宮的子宮腺肌瘤患者40例,在腹腔鏡及陰道超聲全程監(jiān)控和引導(dǎo)下,將微波針置入子宮腺肌瘤體內(nèi)進行微波消融。結(jié)果 40例患者(64個)病灶成功消融,無一例出現(xiàn)損傷周圍重要器官、血管等情況,術(shù)中出血極少;術(shù)后月經(jīng)量、痛經(jīng)程度均明顯改善,暫未見明顯復(fù)發(fā);術(shù)后1個月、3個月、6個月及1年隨訪子宮體積分別為(135.0±73.2)cm~3、(108.2±62.9)cm~3、(91.4±58.4)cm~3、(84.8±50.0)cm~3,均小于術(shù)前的(207.2±97.4)cm~3,差異有統(tǒng)計學(xué)意義(P0.01);術(shù)后1個月、3個月、6個月及1年病灶體積分別為(42.3±34.2)cm~3、(30.6±27.4)cm~3、(24.7±23.0)cm~3、(23.0±19.4)cm~3,均小于術(shù)前的(67.9±48.2)cm~3,差異有統(tǒng)計學(xué)意義(P0.01);實驗室檢查CA125及CA199與術(shù)前相比,差異均有統(tǒng)計學(xué)意義(P0.01)。結(jié)論微波消融子宮腺肌瘤作為一種保留子宮且解決患者痛苦的微創(chuàng)技術(shù),在腹腔鏡的監(jiān)測下進行,更安全、實時,有望成為治療子宮腺肌瘤的新途徑。
[Abstract]:Objective to investigate the short-term curative effect and clinical application value of transvaginal ultrasound guided percutaneous microwave ablation for uterine adenomyoma. Materials and methods the degree of dysmenorrhea in Wuhan Central Hospital from October 2015 to October 2016 was selected. Forty patients with adenomyoma of the uterus who were not treated with conservative treatment but who did not want to remove the uterus were monitored and guided by laparoscopy and vaginal ultrasound. Results 40 patients (64 lesions) were successfully ablated with microwave needle in adenomyoma of uterus. The degree of dysmenorrhea was improved obviously, but no recurrence was found. At 1 month, 3 months, 6 months and 1 year, the volume of uterus was 135.0 鹵73.2 cm ~ (-1). The volume of uterus was 108.2 鹵62.9 cm ~ (-1) (91.4 鹵58.4) (84.8 鹵50.0) cm ~ (3), which was lower than that of preoperative (207.2 鹵97.4) cm ~ (3). The difference was significant (P < 0.01), and the volume of lesion was 42.3 鹵34.2 ~ 30.6 鹵27.4cm ~ 324.7 鹵23.0cm ~ 33.0 鹵19.4cm ~ (-1), which was lower than that of preoperative (67.9 鹵48.4cm ~ (3cm)), 30.6 鹵27.4cm ~ (3t) ~ 324.7 鹵23.0cm ~ (3), respectively (P = 0.01), and the difference was significant (P < 0.01) after 1 month, 3 months, 6 months and 1 year after operation, the volume of lesion was 42.3 鹵34.2cm ~ (30.6 鹵27.4) cm ~ (-1), respectively, which was 23.0 鹵19.4cm ~ (-1). CA125 and CA199 were compared with those before operation. Conclusion Microwave ablation of uterine adenomyoma, as a minimally invasive technique to preserve the uterus and solve the pain of the patients, is more safe and real-time under the monitoring of laparoscopy, which is expected to be a new approach for the treatment of uterine adenomyoma.
【作者單位】： 華中科技大學(xué)同濟醫(yī)學(xué)院附屬武漢市中心醫(yī)院超聲影像科;
【分類號】：R445.1;R737.33

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