High Intensity Focused Ultrasound Treatment Of Uterine Fibroids Clinical Research

OBJECTIVE:In recent years,the incidence of uterine fibroids continues to rise,seriously affecting women's health.The current treatment of uterine fibroids is still based on drugs and surgical treatment,including myomectomy,total hysterectomy,subtotal resection,through the abdomen,laparoscopic,hysteroscopy,transvaginal and other the way.High intensity focused ultrasound is a newly emerged non-invasive surgical technique.HIFU has been proven to have a therapeutic effect on a variety of tumors,with minimal invasive,no radiation,rapid recovery after treatment,and no serious complications.This project intends to explore the efficacy of HIFU in the treatment of uterine fibroids through clinical case analysis,and preliminary discussion of the safety of its treatment,to provide new ideas for the micro-non-invasive treatment of uterine fibroids.METHODS:Selected from September 2015 to September 2016 in Fuzhou Maternal and Child Health Hospital for treatment,and followed up for one year in 83 patients with uterine fibroids.Age 25-57 years old,average age 43.7 years ± 5.7 years old.Patients with menstrual flow due to blood clots,prolonged menstruation,dysmenorrhea,mild anemia,etc.The patient volunteered to receive HIFU treatment.The patient had no other gynecological diseases,no coagulation dysfunction,normal heart,brain,liver,kidney,and lung function.In the past 3 months,she had not received hormone drugs and related treatments.She was not pregnant or breastfeeding.Among them,there were 102 cases of single leiomyomas and 3 cases of multiple leiomyomas(2-3 cases).In accordance with the site of fibroids were divided into:anterior wall fibroids in 55 cases,27 cases of posterior wall fibroids,uterine fibroids in 2 cases,7 cases of wall fibroids.The maximum diameter of fibroids is 2.4-11cm,and the maximum volume of fibroids is 460.77 cm3.The patients were followed up at 3,6 and 12 months after treatment.RESULTS:(1)After 3 months,6 months and 12 months of treatment,the volume of uterine fibroids was significantly reduced.The volume of uterine fibroids decreased from 76.55±89.6 cm3 before treatment to 54.07±67.37 cm3 and 50.4±60.85 cm3,respectively.49.07±67.96 cm3.(2)Significant differences in volume changes of uterus and fibroids before and after treatment.There was no significant difference in volume reduction between different time periods(F=0.167,P=0.684),suggesting that there was no significant change in volume reduction after 3 months of treatment.(3)After 12 months of treatment,the severity of dysmenorrhea was reduced in the patients,which was statistically significant.(4)After 12 months of treatment,62.5%(5/8)of the patients had symptoms of rectal compression and no significant side effects.(5)After 12 months of treatment,menstruation returned to normal in 82.6%(19/23)of patients and no abnormal menstrual flow was observed.(6)There was no statistically significant difference in the effect of age,tumor volume,and body mass index BMI on treatment outcomes.(7)A small number of patients experienced abdominal pain,vaginal bleeding,soreness at the waist,frequent urination,and urinary urgency,which could be restored after rest.CONCLUSION:(1)HIFU treatment of uterine fibroids,fibroids after treatment was smaller than the former,the clinical symptoms reduced,proved effective treatment.(2)The uterine fibroids with the tumor located at the posterior wall and having a volume of 100 cm3 or less have a deeper position and cannot be fully struck,therefor affecting the therapeutic effect.(3)Age,tumor volume,and body mass index did not affect the efficacy of HIFU in the treatment of uterine fibroids.(4)Abdominal pain,backache,vaginal bleeding,bladder irritation,and skin burns are common complications that are generally mild and can be relieved by themselves.(5)After HIFU treatment,their future pregnancy outcomes were largely unaffected.