摘要
目的 探讨高强度聚焦超声(HIFU)消融对子宫肌瘤患者的治疗效果研究和影响因素.方法 将在我院就诊且明确诊断为子宫肌瘤的200例患者作为研究对象,并依据子宫肌瘤消融率将患者分为显效组、有效组及无效组.比较子宫肌瘤在HIFU消融治疗前,治疗后3、12个月的肌瘤体积大小.对治疗效果有显著影响的因素先进行单因素研究,随后将有统计学意义的指标进行多因素Logisitic回归分析,探究HIFU消融治疗子宫肌瘤效果及影响因素.结果 200例子宫肌瘤患者均完成HIFU消融治疗,治疗前子宫肌瘤平均体积、治疗后3、12个月子宫肌瘤平均体积相比较,差异有统计学意义(P＜0.05).单因素分析结果表明,患者年龄、治疗过程中总辐照、治疗功率、总能量、治疗体积、治疗强度、手术时长,对子宫肌瘤HIFU消融率无影响,差异均无统计学意义(P＞0.05);而腹壁脂肪厚度、肌瘤距骶尾部距离、肌瘤直径大小、肌瘤位置、T1WI、T2WI信号类型对子宫肌瘤HIFU消融有影响,差异有统计学意义(P＜0.05).进一步多因素分析结果显示,腹壁脂肪厚度、肌瘤距骶尾部距离、肌瘤直径大小、肌瘤位置、T1WI、T2WI信号类型对子宫肌瘤HIFU消融有影响,差异有统计学意义(P＜0.05).结论 HIFU消融对子宫肌瘤治疗有效.同时HIFU治疗子宫肌瘤消融率受多种因素的影响,子宫前壁、腹壁脂肪厚度越薄、距离骶尾部距离大、肌瘤直径≥50 mm、T1WI低强化、T2WI低密度信号的子宫肌瘤更容易消融.
Abstract
Objective To explore the therapeutic effect and influencing factors of high-intensity focused ultrasound(HI-FU)ablation on patients with uterine fibroids.Methods A total of 200 patients with definite diagnosis of uterine fibroids in our hospital were selected as the study objects,and the patients were divided into obvious group,effective group and ineffective group according to the ablation rate of uterine fibroids.The volume of fibroids was compared before HIFU ablation treatment and 3 and 12 months after treatment.The factors that had a significant impact on the treatment effect were first studied univariately,and then the multivariate Logisitic regression analysis of statistically significant indicators was performed to explore the efficacy and influencing factors of HIFU ablation in the treatment of uterine fibroids.Results 200 patients with uterine fibroids completed HIFU ablation treatment,and the average volume of uterine fibroids before treatment and the average volume of uterine fibroids at 3 and 12 months after treatment were significantly different(P＜0.05).The results of univariate analysis showed that the patient's age,total irradia-tion,therapeutic power,total energy,treatment volume,treatment intensity,and operation duration had no effect on the ablation rate of HIFU for uterine fibroids,and the differences were not statistically significant(P＞0.05).However,the abdominal wall fat thickness,the distance between the fibroid and the sacrococcygeal region,the diameter of the fibroid,the location of the fibroid,and the signal type of T1WI and T2WI had a statistically significant effect on the ablation of uterine fibroids(P＜0.05).Further multi-variate analysis showed that abdominal wall fat thickness,fibroid distance from sacrococcygeal region,fibroid diameter,fibroid loca-tion,T1WI and T2WI signal types had significant effects on HIFU ablation of uterine fibroids(P＜0.05).Conclusion HIFU ab-lation was effective in the treatment of uterine fibroids.At the same time,the ablation rate of uterine fibroids treated with HIFU is affected by a variety of factors,and uterine fibroids with thinner fat thickness in the anterior and abdominal walls of the uterus,grea-ter distance from the sacrococcygeal,fibroid diameter of ≥50 mm,T1WI low enhancement,and T2WI low density signal are easier to ablation.
维普
万方数据