CAJ | 학술논문

目的探讨超声消融治疗子宫肌瘤的近期常见并发症及其影响因素,为合理选择适应证、减少并发症提供理论依据.方法回顾性分析超声消融治疗的子宫肌瘤患者171例(共231个肌瘤)的临床资料,分类总结治疗后近期的常见并发症,分析其影响因素.结果超声消融治疗子宫肌瘤的常见并发症有:下腹疼痛71.9%(123/171)、阴道血性分泌物17.5%(30/171)、骶尾部和(或)臀部疼痛8.2%(14/171)、治疗区域皮肤水疱7.6%(13/171)、下肢疼痛4.7%(8/171)、血尿2.9%(5/171)、发热1.8%(3/171)等,无严重并发症发生.多重logistic回归多因素分析显示,下腹疼痛的影响因素有:肌瘤体积、治疗时间、平均功率(P<0.05);骶尾部和(或)臀部疼痛的影响因素有:肌瘤的位置[子宫后壁肌瘤治疗后,骶尾部和(或)臀部疼痛发生率高于肌瘤位于其他位置者,P<0.05];阴道血性分泌物的影响因素有:治疗时间、肌瘤类型(黏膜下>肌壁间>浆膜下,P<0.05);治疗区域皮肤水疱的影响因素有:治疗时间(P<0.05);下肢疼痛、血尿、发热的各影响因素间比较,差异无统计学意义(P>0.05).结论超声消融治疗子宫肌瘤最常见的并发症为下腹疼痛,治疗功率和治疗时间可能是影响并发症发生的重要因素.
목적 탐토초성소융치료자궁기류적근기상견병발증급기영향인소,위합리선택괄응증、감소병발증제공이론의거.방법 회고성분석초성소융치료적자궁기류환자171례(공231개기류)적림상자료,분류총결치료후근기적상견병발증,분석기영향인소.결과 초성소융치료자궁기류적상견병발증유:하복동통71.9%(123/171)、음도혈성분비물17.5%(30/171)、저미부화(혹)둔부동통8.2%(14/171)、치료구역피부수포7.6%(13/171)、하지동통4.7%(8/171)、혈뇨2.9%(5/171)、발열1.8%(3/171)등,무엄중병발증발생.다중logistic회귀다인소분석현시,하복동통적영향인소유:기류체적、치료시간、평균공솔(P<0.05);저미부화(혹)둔부동통적영향인소유:기류적위치[자궁후벽기류치료후,저미부화(혹)둔부동통발생솔고우기류위우기타위치자,P<0.05];음도혈성분비물적영향인소유:치료시간、기류류형(점막하>기벽간>장막하,P<0.05);치료구역피부수포적영향인소유:치료시간(P<0.05);하지동통、혈뇨、발열적각영향인소간비교,차이무통계학의의(P>0.05).결론 초성소융치료자궁기류최상견적병발증위하복동통,치료공솔화치료시간가능시영향병발증발생적중요인소.
Objective To analysis complications and its associated risk factors of high intensity focused ultrasound (HIFU) in treatment of uterine leiomyoma for selecting rationale indicated patients and reducing complications. Methods Medical documents of 171 patients with 231 leiomyomas in total treated by HIFU were studied retrospectively. Common complications were categorized and analyzed, the relationship between risk factors and complications were studied. Results Common complications in treatment of uterine leiomyomas by HIFU were 71.9% (123/171) of abdominal pain, 17.5% (30/171) of vaginal bloody discharge, 8.2% (14/171) of sacroiliac or buttock pain, 7. 6% (13/171) of skin blister,4. 7% (8/171) of leg pain, 2. 9% (5/171) of hematuria and 1.8% (3/171) of febrile. By logistic regression analysis, the factor correlated with abdominal pain included diameter of uterine leiomyomas,sonication time and average power (P < 0. 05). The factor correlated with sacroiliac or buttock pain was uterine leiomyomas located in posteriors of uterine wall(P <0. 05); the factors correlated with vaginal bloody discharge were sonication time and type of uterine leiomyomas (submucous > intramural > subserous, P <0. 05); the factors correlated with skin blister was sonication time (P < 0. 05). There were no statistical relationship between multiple factors and leg pain, hematuria, febrile (P > 0. 05). Conclusion The modality of high-power and short-term treatment might reduce complications of HIFU ablation.