| Objective:To assess the efficacy and safety of high intensity focused ultrasound?HIFU?in the treatment of patients with uterine adenomyosis?AM?.Methods:To review the 64 patients with adenomyosis treated by HIFU at the first people's hospital of neijiang between August 2015 and August 2016.The general conditions of the patients were analyzed,and the changes of symptoms and imaging changes of the patients before and after the operation were analyzed,and the volume ablation of lesions in the intraoperative lesions was calculated by ultrasonography.The clinical symptoms and imaging changes of the patients before and after surgery were statistically analyzed.Between the age of the population aged 20 to 45 years old in the short term without fertility requirements,all have varying degrees of dysmenorrhea,preoperative clinical symptoms and imaging diagnosis of uterine adenomyosis,by positioning ultrasound ablation is feasible,and lesion volume can be calculated through enhanced MRI scanning images,patients are hope get treatment uterine adenomyosis and voluntarily accept HIFU ablation.Will be included in the study of patients admitted after a comprehensive evaluation,improve the routine preoperative examination,pelvic MRI,the tumor series exclude the possibility surgery taboo and malignant tumors,have irregular vaginal bleeding patients requires endometrial biopsy to rule out endometrial lesions,guide ready to clean the intestinal preoperative patients,preoperative cleaning enema.Our application of chongqing sea type rotary technology co.,LTD.,production JC200 focused ultrasound treatment of uterine adenomyosis tumor treatment system,HIFU should be carried out under sedation,analgesia,airborne ultrasound system to monitor the whole process of surgery can be controlled,preoperative and postoperative instantly using sulfur hexafluoride under ultrasonic imaging lesion volume calculation,vaginal bleeding,drainage and postoperative observation with lower limb numbness and other symptoms.The patients were followed up for 3months and 6 months after HIFU.Symptoms of clinical dysmenorrhea[1]include complete remission:complete disappearance of symptoms;Obvious relief:the symptom score decreased by 2 points or more,and the symptoms did not disappear completely.Partial relief:the symptom score decreased by one score,but the dysmenorrhea did not disappear.Invalid:no change in symptom score;Aggravation:the score of symptom score increases.The study was completely alleviated,significantly alleviated and partially alleviated.The clinical symptoms were not alleviated by ineffectiveness and aggravation.The specific method of VAS score[2]is:the VAS card is usually produced by the Chinese medical association pain society.There is a sliding cursor on a 10cm long line with a number in the center of the card.The two ends represent"painless"?0?and"the most severe pain"?10?.The patient faced the unmarked side,and I placed the cursor at the place where the pain was most representative.The doctor faced the scale and recorded the degree of pain.Mild pain?1-3?,moderate pain?4-6?,severe pain?7-10?.Lesion volume calculation method:the lesion size?cm3?=ABC?/6,ABC lesions respectively before and after the longitudinal diameter,transverse diameter and maximum diameter of the product,the preoperative and postoperative uterine adenomyosis lesions on the ultrasonic and recorded.For relief of symptoms in patients with clinical analysis,for patients with preoperative and postoperative 3month and 6 month dysmenorrhea score and changes of the lesion volume application SPSS17.0 statistical software analysis,before and aftertreatmentcomparedwithpairedttestforstatistical analysis.Results:HIFU surgery in March with a total of 38 patients?59%?completely relieve symptoms,eight?13%?patients obviously alleviate symptoms,11?17%?patients symptoms part,7?11%?patients were performer without ease symptoms.After June,a total of 40 cases?63%?patients with completely relieve symptoms,nine?14%?patients obviously alleviate symptoms,symptoms part 9?14%?patients,6 cases?9%?patients without ease symptoms.No symptoms of dysmenorrhea were observed in patients with severe dysmenorrhea after surgery in March and June.The symptom remission rate?remission rate=remission number/total number of cases*100%?was 57?89%?and 58?91%?of the patients after surgery.Preoperative dysmenorrhea score was 5.69±1.65,and the pain score was 2.39±3.13,2.16±2.97 in March and June,respectively,with significant difference?P<0.05?.See table 2?table3.There was a statistically significant difference between June and march compared with march?P<0.05?.Postoperative ultrasound lesion volume?volume calculation method:lesion volume?3 cm?=abc?/6,ABC is the maximum product of the transverse diameter,longitudinal diameter and front and rear diameter of the lesion.?compared with the preoperative has narrowed considerably,the treatment of adenomyosis lesions before was?65.536±53.221?cm3,3?6 months after treatment of adenomyosis lesions respectively?26.291±20.991?cm3 volume,?21.125±18.002?cm3,compared with the preoperative had significant difference?P<0.05?See table 2?table 3.The differences in the volume of lesions between June and march were also statistically significant?P<0.05?.After treatment,the average volume reduction rate of adenomyosis lesions was60%and 68%respectively.Immediate postoperative imaging lesion volume ablation rate under 61 average was 75.41±15.805%,?ablation rate=perfusion area/immediate postoperative lesion volume*100%volume,volume calculation method:the lesion size?3 cm?=abc?/6,abc lesions in a maximum of three diameter online product?.Three of the patients had no angiography due to fluctuation of blood pressure.No complications occurred in 64 patients after follow-up.Conclusion:High intensity focused ultrasound therapy is effective in alleviating dysmenorrhea in patients with adenomyosis and reducing adenomyosis,and there are no complications. |
PDF Full Text Request