Comparative Study Of High Intensity Focused Ultrasound Ablation For Uterine Fibroids With Various Sizes

Objective:Uterine fibroid is a common and frequently occurring disease in women of childbearing age.It is easy to diagnose,but need individualized treatment.High intensity focused ultrasound(HIFU)provides a new choice for the treatment of uterine fibroids.With the development of HIFU treatment on uterine fibroids,people have an intensive study on the effectiveness and safety of HIFU,in which the size of uterine fibroids for HIFU treatment on uterine fibroids is not clear,the purpose of this paper was to investigate the difference of efficacy and safety of HIFU in the treatment of uterine fibroid with various sizes,in order to provide a theoretical basis for the screening and prognosis of HIFU.Methods:This study selected from February 2016 to December 2016 in Sichuan Province,Suining Central Hospital of high intensity focused ultrasound in the treatment of the patients with single uterine fibroids 120 cases,according to the maximum tumor diameter D is divided into the following 4 groups,the first group(1cm<d<3cm)30 cases,second groups(3cm<d<5cm)and the third group(5cm<d<7cm)30 cases,fourth group(d>7cm)30 cases,through the comparison of curative effect after HIFU treatment,including immediate ablation rate,the reduction of uterine fibroids volume follow-up at 1?3months,assessment remission of symptoms after treatment at 3 months by Uterine fibroids Symptom severity Scale(UFS),and adverse reactions and complications after treatment,to analysis and evaluate the clinical efficacy and safety of HIFU in four groups of patients.Results:1.Four groups of patients with general clinical data,including age,BMI,abdominal wall thickness,distance of the deep surface of the fibroids and the sacrum,signal of MRI T2,location,type of fibroids had no significant difference(P>0.05).Four groups are comparable.2.Comparison of dosimetric parameters for the treatment of HIFU,the four groups had no significant difference in sonication power(P>0.05),and the sonication time,the intensity of treatment,the total energy comparison,have obvious difference(P<0.05),tumor diameter increases,the treatment dose was gradually increased.3.All patients were successfully completed the HIFU treatment,there was no significant difference(P>0.05)in the immediate volume ablation rate.4.The rate of reduction of uterine fibroid of Four groups of patients with postoperative follow-up of 1 months uterine(%)were 36.59�15.74,38.73� 19.22,34.84� 14.82 and 33.66�19.66,after 3 months were 53.6�8.80,56.99�21.47,51.25�17.61 and 54.06�22.18,there were no obvious differences between the four groups(P>0.05).5.120 cases of patients with HIFU treatment had 93 cases of patients with symptomatic uterine fibroids,postoperative follow-up of 3 months there were 90 cases of patients with symptom scores decreased in different degree compared with the preoperative and postoperative scores were lower than those before operation(P<0.05),symptom scores were compared between the four groups the rate of decline has no significant difference(P>0.05).6.The adverse reactions reported in the patients included sacrococcygeal pain,abdominal pain,groin pain,buttock pain,radiation pain,skin blanching,and there was no significant difference in the incidence of adverse reactions(P>0.05).The adverse reaction during the follow-up of HIFU after operation,including abdominal pain,fever,sacrococcygeal pain,vaginal discharge,skin damage,and the incidence of lower abdominal pain was the highest,and the incidence of the first?second and third groups was lower than that of the fourth group(P<0.05).There was no significant difference in the incidence of other adverse reactions.According to the SIR classification,postoperative adverse reactions were mild adverse reactions of SIR A-B,and there was no significant difference(P>0.05).Conclusion:1.The greater the diameter of the uterine fibroids,the higher the intensity of ultrasound treatment of uterine fibroids,irradiation time,the total energy more,but the size of fibroids does not affect the short-term efficacy and safety of HIFU treatment.2.HIFU is safe and feasible in ablating various sizes of uterine fibroids,especially for the maximum diameter of less than 7cm can be used as a safe and effective treatment.