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重庆海扶医院
纸质出版日期:2020,
网络出版日期:2020-10-28,
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胡畅. 子宫肌瘤患者高强聚焦超声治疗后妊娠、分娩情况及影响因素分析[J]. 临床超声医学杂志, 2020,22(10).
hu chang. Analysis of pregnancy and its influencing factors in patients with uterine fibroids after high intensity focused ultrasound therapy[J]. Journal of Clinical Ultrasound in Medicine, 2020,22(10).
目的:探讨子宫肌瘤患者高强聚焦超声(high intensity focused ultrasound
HIFU) 治疗后妊娠情况及影响因素,为优化子宫肌瘤患者治疗方案提供理论依据。方法:纳入2014年6月至2017年6月因子宫肌瘤行海扶手术治疗的98例有生育要求的患者,定期随访,了解术后妊娠情况及产科并发症发生情况。结果:(1)截止2018年6月,本研究98例患者共有71例患者89次妊娠。妊娠组与非妊娠组在年龄及不孕时间上差异有统计学意义(P<0.05),肌瘤大小和肌瘤类型、孕产次等差异无统计学意义(P>0.05)。(2)89次妊娠结局为分娩68次(顺产21次,剖宫产47次),自然流产9次,人工流产4次,中孕畸形引产1次,宫外孕1次,6例妊娠中。(3)68次分娩发生产科并发症12例,其中早产2例,中央性前置胎盘2例,边缘性前置胎盘3例,胎盘植入2例,胎盘粘连3例。(4)不同类型肌瘤术后妊娠时产科并发症发生率有明显差异(P<0.05),主要表现为前置胎盘、胎盘粘连和胎盘植入。结论:HIFU治疗子宫肌瘤安全有效,可作为有生育要求患者治疗子宫肌瘤的新选择。
Objective To investigate the pregnancy status and influencing factors of patients with uterine fibroids after high-intensity focused ultrasound(HIFU) therapy
and to provide theoretical basis for optimizing the treatment of patients with uterine fibroids. Methods Ninety-eight patients with fertility requirements who underwent hysteroscopic surgery for uterine fibroids from June 2014 to June 2017 were enrolled. Regular follow-up was conducted to understand postoperative pregnancy and obstetric complications. Results (1) As of June 2018
98 patients in this study had a total of 71 patients with 89 pregnancies. There was significant difference in age and infertility between the pregnant group and the non-pregnant group (P<0.05). There was no significant difference in the size of fibroids
type of fibroids and maternal parity (P>0.05). (2) 89 pregnancy outcomes were 68 births (21 births
47 cesarean section)
9 spontaneous abortions
4 abortions
1 induction of abnormality in mid-pregnancy
1 ectopic pregnancy
and 6 cases of pregnancy. (3) There were 12 complications in 68 births
including 2 cases of premature delivery
2 cases of central placenta previa
3 cases of marginal placenta previa
2 cases of placenta implantation
and 3 cases of placenta adhesion. (4) Obstetric complications of submucosal fibroids were significantly increased compared with the other groups
the difference was statistically significant (P<0.05)
mainly manifested as placenta previa
placental adhesion and placenta implantation. Conclusion HIFU is safe and effective in the treatment of uterine fibroids. It can be used as a new option for the treatment of uterine fibroids in patients with fertility requirements.
宫肌瘤 高强聚焦超声 妊娠结局
Uterine fibroids High intensity focused ultrasound Pregnancy outcome
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