目的 研究超声引导经皮微波消融(PMA)治疗症状性无蒂浆膜下子宫肌瘤的安全性及有效性。 方法 研究37例症状性无蒂浆膜下肌瘤患者消融后肌瘤组织坏死情况、副作用及并发症,分析治疗后3、6及12个月肌瘤体积(FV)及子宫肌瘤症状及生活质量(UFS-QOL)评分变化。 结果 所有患者均1次消融成功,均无严重并发症;治疗后3、6及12个月FV分别为(67.7±47.4)cm³、(40.3±25.8)cm³和(27.3±26.1)cm³,较治疗前(182.6±82.5)cm³,差异有统计学意义,缩小率分别是64.8 %,77.5 %,82.7 %。治疗后3、6、12个月症状严重程度评分(SSS)分别为(13.5±4.1)、(13.7±3.1)和(12.4±2.9),生活质量(HRQL)分别为(88.3±10.6)、(86.6±8.3)和(86.7±9.1),与治疗前[(36.9±4.7)、(46.8±9.3)]比较明显改善,差异有统计学意义;治疗后3个月HRQL与健康人水平(86.4±17.7)比较,治疗后6、12个月SSS、HRQL与治疗后3个月比较,治疗后6个月与12个月比较,差异均无统计学意义。 结论 超声引导PMA治疗无蒂浆膜下子宫肌瘤安全有效,为无蒂浆膜下肌瘤保留子宫治疗可供选择的方法。

Objective To evaluate safety and efficiency of ultrasound-guided percutaneous microwave ablation (PMA) therapy for symptomatic sessile subserous uterine fibroids. Methods Thirty-seven women with symptomatic sessile subserous uterine fibroids underwent PMA. Necrosis of fibroid tissue after treatment, side-effects, and complications were recorded. The fibroid volume reduction ratio (FV) and the Uterine Fibroid Symptoms and Quality Of Life Questionnaire (UFS-QOL) at 3-, 6-, and 12-month of follow-up were evaluated. Results All patients completed therapy with a single ablation, No major complications were observed. The FV at 3-, 6- and 12-month of follow-up were 64.8%, 77.5%, and 82.7%, respectively. The symptoms severity (SSS) and health-related quality of life (HRQL) scores at 3-month of follow-up changed from 36.9 4.7 and 46.8 9.3 to 13.5 4.1 and 88.3 10.6, respectively, with statistical significances. The two scores of HRQL at 3-month of follow-up had no statistical difference compared with the healthy controls, and the two scores remained stable at 6- and 12- month of follow-up. Conclusion Ultrasound-guided PMA is a safe and effective therapy for sessile subserous uterine fibroids, and can be another uterine-conserving treatment for these patients.