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碘化油联合高强度聚焦超声(HIFU)治疗子宫肌瘤的临床探究

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遵义医学院硕士学位论文 碘化油联合高强度聚焦超声(HIFU)治疗子宫肌瘤的临床研究 碘化油联合高强度聚焦超声(…FU) 治疗子宫肌瘤的临床研究 中文摘要 目的:探讨碘化油联合高强度聚焦超声(HIFU)治疗子宫肌瘤的临床效果及安全性。 方法:收集2010年9月一2011年6月在遵义医学院附属医院妇科诊断为子宫肌瘤的 患者60例,随机分为2组,用药组30例,对照组30例。用药组给予瘤体内注入碘 化油1 ml,30分钟后行HIFU治疗;对照组单行HIFU治疗。依照国际介入放射治疗 学会SIR评价表评价碘化油肌瘤内注射的安全性;比较两组HIFU消融能效因子(EEF 消融单位体积所需辐照能量)及治疗后3月、6月肌瘤体积缩小率。 结果:两组患者辐照中均出现靶区灰阶的增强变化,用药组以团块状强回声为主,对 照组以非团块状回声为主。用药组达到治疗标准的*均消融时间为576.80+123.71 S、消融肌瘤所需要的总辐照能量为207128.8±50026.24 J、消融单位体积瘤体组织 所需要的能效因子为5.84±1.25 J/ram3;对照组达到治疗标准的*均消融时间为 1209.37±276.80 S、消融肌瘤所需要的总辐照能量为467317.4±87086.0 J、消融 单位体积瘤体组织所需要的能效因子为9.03±2.45 J/ram3,与用药组比较,差异均具 有显著性(K0.05)。对照组术后3、6个月肌瘤体积分别为(37828.31±2794.68 mm3) 和(21914.77±1984.05 iilm3),与术前(74382.07_+5162.78 mm3)比较,差异有显著性 (P<0.01)。用药组术后3、6个月肌瘤体积分别为(35745.05±5047.86ram3)和 (17397.46±2881.33 mm3),与术前(75194.93±8028.62 mm3)比较,差异有显著性(尸 <0.01)。用药组与对照组术后3、6个月肌瘤体积缩小率分别为0.61±0.13、0.83 ±0.08和0.51±0.09、O.73±0.10,两组相比较,差异均具有显著性(P<0.01)。 经线性回归分析,两组患者肌瘤体积与时间的回归方程均具有统计学意义(尸<O.01), 肌瘤体积均有随时间缩小的趋势。 结论:碘化油具有增强子宫肌瘤HIFU辐照能量沉积的效果;碘化油联合HIFU治疗 子宫肌瘤可提高HIFU治疗子宫肌瘤的疗效,且安全性好。 关键词:子宫肌瘤;碘化油;高强度聚焦超声;能效因子 5 遵义医学院硕士学位论文 碘化油联合高强度聚焦超声(HmU)治疗子宫肌瘤的临床研究 A Clinic Study about Ablation Leiomyoma by combination肼U and Iodized Oil Abstract Objective:To explore the efficacy and safety of ablation leiomyoma by combination oil. HIFU(High intensity focused ultrasound,HIFU)with iodized Methods:60 Affiliated patients diagnosed wim leiomyoma in gynecology department of the Hospital of Znnyi Medical College during Septernber,201 0 to June,201 1 were randomly divided into two groups,the treatment group the control group with 30 cases equally.1 ml iodized oil was HIFU injected into the myoma in treatment group 30 minutes before by HIFU.The ablation.While patients in the control group were only ablated security of the process of iodized oil injection Was evaluated by SIR classifications system. size of the myoma in The energy efficiency factor(EEF)Was compared in two groups,The groups were observed at the time of 3 in taIl:get two and 6 months after HIFU ablation. Results:Enhanced grayscale area were observed both in two groups treatment while group, inn HIFU ablation,the grayscale were higher曲d and ball-shaped in non but in control group,the grayscale were lower Y ball?shaped.The time,energ were 576.80士1 23.7 1 s, and EEF needed for曲lation and myoma in treatment group 207,128.8士50026.24 J P the 5.84土1.25 J/ram3 respectively,while in control grou 1209.37士276.80 s,467,317.4士87086.0 J


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