本文選題：子宮腫瘤　切入點(diǎn)：肌瘤　出處：《中國(guó)介入影像與治療學(xué)》2017年05期 　論文類型：期刊論文

【摘要】：目的探討子宮肌瘤行高強(qiáng)度聚焦超聲(HIFU)消融治療后妊娠者孕產(chǎn)期靶肌瘤的轉(zhuǎn)歸情況及妊娠結(jié)局。方法選擇在我院接受HIFU治療后妊娠者123例,收集臨床資料、肌瘤的影像學(xué)特征信息,進(jìn)行孕產(chǎn)期靶肌瘤相關(guān)情況隨訪。結(jié)果術(shù)后中位隨訪時(shí)間為3年,與妊娠前比較,60例(60/123,48.78%)患者孕早中期靶肌瘤增大,平均增大直徑(2.1±1.6)cm;22例剖宮產(chǎn)+剔除靶肌瘤患者中,與孕前、孕早中期相比,分別有3例(3/22,13.63%)、13例(13/22,59.09%)發(fā)生縮小;產(chǎn)后3個(gè)月B超復(fù)查的27例患者中,靶肌瘤與孕前、孕早中期相比,分別有12例(12/27,44.44%)、18例(18/27,66.67%)靶肌瘤縮小。123例HIFU術(shù)后妊娠者中,成功分娩84例、正在妊娠18例、人工流產(chǎn)4例,自然流產(chǎn)17例,成功分娩和自然流產(chǎn)患者術(shù)前妊娠丟失史、年齡、肌瘤數(shù)量、孕期肌瘤增大發(fā)生率差異有統(tǒng)計(jì)學(xué)意義(P均0.05),孕期靶肌瘤增大值差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論子宮肌瘤超聲消融后妊娠,部分靶肌瘤在孕早中期呈暫時(shí)增大,但仍小于HIFU術(shù)前靶肌瘤最大徑;妊娠晚期靶肌瘤較妊娠早中期無明顯變化,產(chǎn)后靶肌瘤呈逐漸縮小趨勢(shì)。HIFU術(shù)后妊娠,孕期靶肌瘤增長(zhǎng)程度對(duì)妊娠結(jié)局無不良影響。
[Abstract]:Objective to investigate the outcome and pregnancy outcome of target myoma in pregnancy after high intensity focused ultrasound (HIFU) ablation of uterine leiomyoma. Methods 123 cases of pregnancy after HIFU in our hospital were selected and the clinical data were collected. Results the median follow-up time was 3 years. Compared with pre-pregnancy, 60 cases (60 / 123) with target leiomyoma increased in the second trimester of pregnancy. In 22 patients with target leiomyoma removed by cesarean section with an average diameter of 2.1 鹵1.6 cm ~ (-1), there were 3 / 22 / 2213.63 / 13 cases with 13 / 2259.09% of 13 / 22 / 2259.09) respectively, compared with those before and in the second trimester of pregnancy; in 27 cases of B-ultrasound reexamination after 3 months of postpartum, the target fibroids were compared with those before and in the second trimester of pregnancy. There were 12 cases of 12 / 27 / 27 44.44 cases with 18 cases of 18 cases of 18 / 2766.67 cases of target myoma shrinking. Of the 123 cases of pregnancy after HIFU, 84 cases were successfully delivered, 18 cases were pregnant, 4 cases were induced abortion, 17 cases were spontaneous abortion, the history of pregnancy loss before operation and age in the patients with successful delivery and spontaneous abortion. There were significant differences in the number of leiomyomas and the incidence of leiomyoma enlargement during pregnancy (P < 0.05), but there was no significant difference in the increase of target leiomyoma during pregnancy (P < 0.05). Conclusion after ultrasound ablation of uterine leiomyoma, some target leiomyomas are temporarily increased in the first and second trimester of pregnancy. But it was still smaller than the maximum diameter of the target leiomyoma before HIFU, and there was no significant change in the target myoma in the third trimester than in the early and second trimester of pregnancy. The postpartum target myoma showed a decreasing trend of pregnancy. The growth of the target leiomyoma during pregnancy had no adverse effect on the outcome of pregnancy.
【作者單位】： 重慶醫(yī)科大學(xué)生物醫(yī)學(xué)工程學(xué)院省部共建國(guó)家重點(diǎn)實(shí)驗(yàn)室培育基地—重慶市超聲醫(yī)學(xué)工程重點(diǎn)實(shí)驗(yàn)室重慶市生物醫(yī)學(xué)工程學(xué)重點(diǎn)實(shí)驗(yàn)室;重慶醫(yī)科大學(xué)附屬第一醫(yī)院超聲消融治療中心;
【基金】：國(guó)家“十二五”科技支撐計(jì)劃課題項(xiàng)目(2011BAI14B01)
【分類號(hào)】：R445.1;R737.33

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