The Efficacy Evaluation Of High Intensity Focused Ultrasound In The Treatment Of Uterine Fibroids And The Establishment Of Therapeutic Effect Pred Iction Model

Uterine fibroids is a common benign tumor of childbearing-age women,at present,the treatment is given priority to surgical resection,but the invasive operation and traumatic is larger in surgical resection than other methods.The characteristics of High Intensity Focused Ultrasound(HIFU)is non-intrusive and less trauma,which make it take part in the treatment of uterine fibroids.Objective(1)To evaluate the safety and efficacy of HIFU in the treatment of uterine fibroids;(2)To establish the forecast model of HIFU treatment in uterine fibroids.Materials and methods(1)In our hospital,517 patients with uterine fibroids accepted HIFU treatment from April 27,2017 to March 1,2020 were included.Following up for 12 months after HIFU treatment,we record the Uterine fibroids shrinkage rate,the symptom remission rate,the condition of fibroid reintervention,and the score of Uterine Fibroid Symptom and Health-related Quality of Life(UFS-QOL),and collect the adverse reactions during HIFU treatment and the pregnancy outcome after HIFU treatment;(2)For further analysis,we make Non-Perfused Volume Ratio(NPVR)the dependent variables,make the clinical features and uterine fibroids characteristics the independent variables.By analysing the correlation between variables,we construct the therapeutic effect prediction model of HIFU treatment in uterine fibroids.Results(1)In this study,517 patients with uterine fibroids who underwent HIFU treatment were included.Follow-up to 12 months after treatment,we excluded 52 patients who were lost to follow-up,and 465 patients left were evaluated.Among them.419 patients were effective,the symptom remission rate was 90.11%.46 cases were ineffective,of which 27 cases were reintervened,the reintervention rate was 5.81%.After 12 months of follow-up,Uterine fibroids shrinkage rate was 40.39±8.76(95%Confidence Interval[CI]:23.22-57.56),the UFS score decreased to 9.20±6.93(95%CI:8.59-9.84)and the QOL score increased to 81.77±7.16(95%CI:81.09-82.42).No serious adverse reactions occurred.47 cases were pregnant within 1 year after HIFU treatment,accounts for 23%of women who need to have children,11 cases were natural labor,15 cases were cesarean delivery,without adverse pregnancy outcome.(2)We found that the NPVR was found to be correlated with Body Mass Index(BMI),the location of fibroids in uterine,T2 signal type of fibroids,T1 enhanced type of fibroids and uterine position(P<0.05).The predictive model of NPVR was Y=-0.344X1+0.192X2+0.312X3+0.112X4+0.085X5(Y represents NPVR,X1 represents BMI,X2 represents the location of fibroids i n uterine.X3 represents T2 signal type of fibroids,X4 represents T1 enhanced type of fibroids,Xs represents uterine position).Conclusion(1)HIFU is safe and effective in the treatment of patients with uterine fibroids,the size of the fibroids decreased,patients,symptoms related with uterine fibroids were significantly relieved and quality of life was improved within 12 months after HIFU treatment.(2)We can use BMI、the location of fibroids in uterine、T2 signal type of fibroids、T1 enhanced type of fibroids and uterine position to predict NPVR.