The Clinical Research Of Efficacy And Safty About High-intensity Focused Ultrasound In Treatment Of Multiple Uterine Fibroids

Background: Uterine fibroids are the commonest benign uterinetumors in women during their reproductive years. They can normally causea multitude of symptoms such as abnormal uterine bleeding, a feeling oflumbosacral region pressure, urinary incontinence or retention, constipation,pain, infertility and miscarriage; and that are the reasons for patients askingfor doctors. The more fibroids, the bigger uterine volume, and symptomswill be more severe. For the pase few years,more and more doctors seek thepossibility of minimally invasive uterus-sparing alternatives for thetreatment of uterine fibroids.Some of these therapies include uterine arteryfibroids(UAE), Magnetic Resonance Imaging-Guided High IntensityFocused Ultrasound(MRgHIFU), Ultrasound-Guided High IntensityFocused Ultrasound (USgHIFU) and ultrasound-guided ablation. HIFU is anew and non-invasive technology. Abundant clinical research certified thesafety, efficient and economical about HIFU treating uterine fibroids. Atpresent, the research of HIFU treating fibroids need large-scale,muti-centerrandomized controlled trial to confirm the safety and efficient problems. Objective: To investigate the clinical application of HIFU treatmentfor patients with multiply uterine fibroids, and discuss the safety andefficient of HIFU. Provided theoretical evidence for the doctors andpatients how to choose the best way of treating.Methods: Retrospective analysis the patients from The First AffiliatedHospital of Chongqing Medical University during2012.1-2013.5receivedHIFU therapy for uterine fibroids.The patients were evaluated with themultiple uterine fibroids and had been followed-up. Analyze28patientswith86fibroids. The patients have at least2fibroids, and not more than7fibroids, with diameter range form1cm to10cm.review the adverse effectsduring and after the treatment, the therapy and the recovery time. Using thecontrast T1Weighted Image to analysis the ablation rate after the treatmentimmediately. At1,3and6months after treatment, uterines and fibroidsvolumes were evaluated by ultrasound, and compared with the preoperativeultrasound volumes. And compared the difference ablation rate of differentkinds of fibroids. The change of clinical symptoms were evaluated in the6months.Results: All patients complete the treatment successfully,adverseeffects were SIR A-B, by observing or taking some medicine can recovery.No serious complication was observed. The normal activity recover during2hours or7days. The average ablation rate of target fibroids was(80.67±18.45)%, significant efficacy rate was91.86%(79/86). After1 month follow-up16patients with50fibroids, After3months follow-up17patients with60fibroids, After6months follow-up12patients with39fibroids.The average shrinkage of uterine volumes were(16.92±14.79)%,(30.57±19.80)%,(31.55±12.92)%, respectively; and the average shrinkageof fibroids volumes were(26.32±35.94)%,(46.12±22.20)%,(58.31±20.34)%. All had statistical difference(P＜0.05). No ablation ratedifference of different kinds of fibroids(P＞0.05). The symptoms relief ratereached96.43%(27/28)in the6months.Conclusions: It was safe and efficacy of HIFU ablation in the treatmentof multiple fibroids. Treat multiple fibroids will prolong the treatment timecompared with single fibroid,and the influence factors are morecomplicated. Besides, HIFU technology can non-invasive treat the fibroidsand keep the uterine with less adverse effects and efficient.