Comparison Of High Intensity Focused Ultrasound Ablation Of Uterine Fibroids After Ablation Of Patients With Uterine Fibroids

Objective: High intensity focused ultrasound ablation of uterine fibroids and uterine myomectomy postoperative recurrence and pregnancy outcome of pregnancy;Objective to investigate the feasibility and postoperative pregnancy of uterine fibroids ablation with high intensity focused ultrasound(HIFU)in the treatment of uterine fibroids.Method: From July 2012 to May 2014 in the second hospital of Hebei Medical University received treatment and fertility requirements in accordance with the inclusion criteria of patients with uterine leiomyoma.This study confirmed by transvaginal color Doppler ultrasonography or MRI examination confirmed 126 cases of myoma of uterus and fertility requirements of patients after treatment in the follow-up of 18 patients were lost,finally the end of the investigation total 108 cases of patients were enrolled and divided into HIFU group and operation group,including 56 cases of HIFU group,operation group 52 cases.HIFU ablation in HIFU group were given uterine myoma;myomectomy group received surgical treatment;observation of two patients Type of patients after 3 months,6 months,12 months,18 months of pregnancy,and to evaluate the outcome of pregnancy.Pregnancy on recurrence,two groups of patients during the follow-up period,compare delivery.Data were analyzed by SPSS19.0 statistical software,count data compared with T in P<0.05 test,the difference was statistically significant.Results:1 This study by transvaginal color Doppler ultrasonography or MRI examination confirmed 108 cases of myoma of uterus and fertility requirements of patients,the HIFU group of 56 cases,52 cases of surgical group.The HIFU group aged between 18-44 years old,the average age was 31.45 + 6.163 years,operation group,age range 19-45 years,mean age 32.62 + 5.752 years,there was no significant difference between the two;and the two groups of patients in age,height,weight,marriage,pregnancy,birth,preoperative with dysmenorrhea,with preoperative abdominal pain,preoperative abnormal CA125,there are no significant difference(P > 0.05);2 Within 18 months after operation,there were 7 patients in the HIFU group,and 6 patients in the surgical group had recurrence.The recurrence rates were 12.5% and 11.5% respectively,and there was no significant difference between the two groups in relapse rate(P > 0.05);3 Within 18 months after operation,there were 18 pregnant women in the HIFU group,and 17 pregnancies in the operation group.The pregnancy rates were 32.14% and 32.69% respectively,and there was no significant difference between the two groups in the pregnancy rate(P > 0.05);4 A comparative analysis of the time of pregnancy in two groups of patients with postoperative pregnancy HIFU group and operation group were 4.53 + 2.52,12.62 + 7.43 months,the average time of pregnancy after operation in HIFU group was significantly lower than the surgical group,two sets of data with significant difference(P < 0.05);5 The age of pregnancy in the two groups was the highest in the two groups,with the highest proportion of 25-34 years,66.67% and 63.15% respectively,while those over 40 years of age had lower rates of 11.11% and 5.88%,respectively;6 Two groups of patients within 18 months of pregnancy in 35 cases,including 18 cases of HIFU group the number of pregnancy,pregnancy surgery group 17 cases.The number of pregnancy after HIFU group and operation group were 2 cases and 1 cases underwent artificial abortion,1 cases occurred in patients with embryo HIFU group,surgery group had 2 cases the embryo of.HIFU group had 9 cases,6 cases of cesarean section,and 3 cases had surgery group,11 cases of cesarean section,HIFU group and operation group during pregnancy and childbirth had no uterine rupture occurred after operation in HIFU group,the cesarean section rate was significantly lower than the surgery group,the data of the two groups had significant difference(P < 0.05);7 According to the type of grouping of uterine fibroids(FIGO type),the following different types of pregnancy after uterine fibroids: 3 cases of type 2(3/9 33.3%),3 cases of type 4(4/17 23.5%),4 cases of type 24(24/65 36.9%),5 cases of type 3(3/12 25%),6 cases of type 1(1/5 20%).There was no significant difference between different types of uterine fibroids after pregnancy(P>0.05).Conclusion: HIFU treatment of uterine fibroids is a safe and effective non-invasive treatment.The myoma of uterus treated by HIFU fertility requirements of patients after pregnancy after surgery,shorten the time of treatment,HIFU has a certain application value of uterine fibroids.