六氟化硫微泡在HIFU治疗T2WI高信号子宫肌瘤中的临床应用
Application of Sulfur Hexafluoride Micro-bubble in the Treatment of T2WI High Signal Uterine Fibroids with High Intensity Focused Ultrasound
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摘要: 目的 探讨六氟化硫微泡在高强度聚焦超声治疗T2高信号子宫肌瘤中的应用价值.方法 选取昆明医科大学第一附属医院36例单发T2高信号子宫肌瘤患者随机分成研究组和对照组,对照组18例患者术中不用六氟化硫微泡,研究组18例患者术中使用六氟化硫微泡.分别记录2组的手术时间(min)、出现块状灰度变化时间(s)、辐照时间(s)、治疗剂量(J),并发症发生的情况及消融率(%).结果 研究组手术时间、出现块状灰度变化时间(s)、辐照时间(s)、治疗剂量分别为(101.51±43.02)min,(856.42±451.14)s,(1077.37±546.23)s,(496 581.81±267 192.31)J,对照组分别为(261.34±85.53)min,(1 833.32±642.67)s,(1 890.21±1 268.43)s,(784 608.31±357 621.45)J,2组各参数相比差异有统计学意义(P<0.05).研究组消融率为83.3%,对照组消融率为55.5%,2组参数相比差异有统计学意义(P<0.05).研究组患者出现全身麻木1例,没有发生治疗区皮肤烧伤.对照组治疗区皮肤Ⅱ°烧伤1例,全身麻木2例,并发症的发生率为1/18(5.5%),2组均未出现肠穿孔、膀胱穿孔等严重并发症.结论 六氟化硫微泡在高强度聚焦超声热消融T2高信号子宫肌瘤中可缩短手术时间,减少并发症,提高消融率,在临床中发挥着重要的应用价值.Abstract: Objective To evaluate clinical value of ultrasound contrast agent the sulfur hexafluoride micro-bubble in the treatment of T2 WI high signal uterine fibroids with high intensity focused ultrasound(HIFU).Methods A total of 36 patients with T2 WI high signal uterine fibroids were randomly divided into experimental group and control group. Eighteen patients in experimental group received HIFU treatment with sulfur hexafluoride micro-bubble before, during and after the operation while another eighteen in control group received HIFU treatment with sulfur hexafluoride micro-bubble only after the operation. We recorded operation time(min),changing time of massive gray(s),irradiation time(s),therapeutic dose(J),incidence of complications and ablation rate(%). Results Operation time, changing time of massive gray, irradiation time,and therapeutic dose in experimental group were(101.51±43.02) min,(856.42±451.14) s,(1 077.37±546.23) s,and(496581.81 ±267192.31) J, respectively while those in control group were(261.34 ±85.53) min,(1833.32±642.67) s,(1 890.21±1 268.43) s,and(784 608.31±357 621.45) J,respectively. Significant differences were found among those parameters between the two groups(P <0.05). Tumor ablation rate in experimental group was 83.3% while that in control group was 55.5%, which was of significant difference between the two groups(P<0.05). One case of muscular stiffness was found in experimental group while one case of second-degree burn and two cases of muscular stiffness were found in the control group.The incidence of complications was 1/18(5.5%). No severe complication like bowel perforation or bladder perforation was found in the two groups. Conclusion The effect of ultrasound contrast agent sulfur hexafluoride micro-bubble can shorten operation time, improve tumor ablation rate and reduce complications and it can play a guiding role in clinical work.
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[1] 邹建中.临床超声治疗学[M].重庆:重庆出版社,2012:5. [2]苏海兵,邹建中,王智彪.高强度聚焦超声的原理及其在肿瘤治疗领域的应用[J].实用心脑肺血管病杂志,2009,17(3):271-272. [3]李晓燕,闫振济.高强度聚焦超声治疗子宫肌瘤98例分析[J].蚌埠医学院学报,2014,39(5):649-650. [4] 曾妮,邹建中.微泡造影剂在高强度聚焦超声治疗子宫肌瘤中的增效作用[J].临床超声医学杂志,2015,17(10):690-691. [5]陈红坚,甘娜,文勇,等.高强度聚焦超声治疗子宫肌瘤和子宫腺肌瘤的临床应用[J].临床超声学杂志,2012,14(2):127-129. [6]胡军,张素敏.高强度聚焦超声治疗子宫肌瘤疗效分析[J].中国实用医刊,2010,37(16):14-16. [7]苏明兰,杨法.不同子宫肌瘤剔除术对比分析.吉林医学,2015,36(3):438-439. [8] 朱志芳.子宫动脉栓塞与子宫肌瘤剔除术治疗子宫肌瘤临床疗效对比分析[J].中外健康文摘,2013,10(5):193. [9]陈衡,黄耀,张卫星.高强度聚焦超声治疗子宫肌瘤对卵巢功能的影响[J].中华妇幼临床医学杂志,2012,8(4):392-394. [10]周英惠.子宫肌瘤药物治疗临床应用概况[J].广西中医药大学学报,2013,16(1):809-820. [11]归倩,张立会,吴富菊,等.子宫肌瘤规范化治疗的研究进展[J].中国老年学杂志,2012,32(32):950-952. [12]郑真真,孙静.子宫肌瘤的治疗进展[J].海南医学,2014,25(3):383-386. [13]张丹丹,高琴,白帆,等.高强度聚焦超声治疗子宫肌瘤的临床疗效分析[J].生殖医学杂志,2015,24(8):668-670. [14]张苗,周洪贵,田小兵.高强度聚焦超声在妇产科的临床应用[J].中华临床医学杂志,2015,9(16):306-309. [15]张学龙,翟昭华,董国礼.MRI评价子宫肌瘤HIFU术的价值及观察周围组织变化的研究进展[J].国际医学放射学杂志,2016,39(3):270-272. [16]何炜,王维,彭松.HIFU联合微泡消融兔肝VX2肿瘤:残瘤检测的病理及影像对比实验[J].浙江大学学报(医学报),2013,42(3):337-344. [17] 沙卫红,李瑜元,王智彪.超声造影剂联合高强度聚焦超声消融兔VX2肝癌的实验研究[J].中华消化杂志,2008,28(6):411-412. [18]沈忠兵,朱向明,倪观太.高强度聚焦超声消融治疗子宫肌瘤的临床评价[J].皖南医学院学报,2014,33(6):543-545. [19]肖雁冰.高强度聚焦超声的原理增效剂及研究现状[J].临床超声医学杂志,2005,7(1):39-41. [20]贺雪梅,熊欣,陈菲,等.微泡造影剂与超声消融子宫肌瘤能效关系的研究[J].临床超声医学杂志,2010,12(9):577-579. [21]曾妮,邹建中.微泡造影剂在高强度聚焦超声治疗子宫肌瘤中的增效作用[J].临床超声医学杂志,2015,17(10):690-692.
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