超声引导经皮微波消融治疗子宫良性病变后自然妊娠情况

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摘要目的分析超声引导经皮穿刺微波消融(UPMWA)治疗症状性子宫肌瘤和子宫腺肌病对患者自然妊娠的影响。方法回顾性分析2007年6月—2014年6月在本院行UPMWA治疗的子宫肌瘤和子宫腺肌病患者治疗后自然妊娠情况及其妊娠结局。结果 UPMWA治疗后自然妊娠率为2.5%(11/446),共13次,宫内孕和宫颈妊娠分别占92.3%(12/13)和7.7%(1/13)。子宫肌瘤和子宫腺肌病自然妊娠分别占54.5%(6/11)和45.5%(5/11),分别受孕7次和6次。自然妊娠的时间为治疗后的5～30个月,平均(14.8±6.6)个月。消融前已生育无再生育要求者8例,宫内妊娠占87.5%(7/8),其中人工终止妊娠6例,胚胎停育(孕48天)1例;宫颈妊娠占12.5%(1/8),人工终止妊娠。继续妊娠3例,其中治疗前曾诊断为“原发不孕”1例,妊娠足月行剖宫产娩出健康胎儿占66.7%(2/3),1例随访至孕26周失访。结论 UPMWA治疗子宫肌瘤和子宫腺肌病对患者自然受孕能力无明显影响,对持续妊娠及妊娠预后的影响应进一步行前瞻性大样本研究。

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	张冰松
	张晶
	韩治宇
	郝艳丽
	杨宇
	许长涛
	徐瑞芳
	马霞

关键词 ：子宫肌瘤, 子宫腺肌病, 微波消融, 自然妊娠

Abstract：Objective To examine the impact of ultrasound-guided percutaneous microwave ablation (UPMWA) for symptomatic uterine fibroids and adenomyosis on natural pregnancy. Methods Medical history and pregnancy outcomes of patients who became pregnant after UPMWA treatment for uterine fibroids and adenomyosis from June 2007 to June 2014 in our hospital were retrospectively reviewed. Results Of the 446 cases, 13 natural pregnancies in 11 women occurred (natural pregnancy rate, 2.5%), including 12 intrauterine pregnancies (92.3%) and 1 cervical pregnancy (7.7%). Among the patients who got pregnant, 6 suffered from uterine fibroids and seven suffered from adenomyosis, with the total pregnancy number of 7 and 6 respectively. The mean time from treatment to conception was (14.8±6.6) months. Among the 11 patients, 8 patients did not have reproductive needs. Six cases of intrauterine pregnancies received induced abortion, and 1 case experienced spontaneous abortion. One patient with cervical pregnancy underwent induced abortion. Among the 3 patients who continued pregnancy, 2 gave birth to a healthy term infant by cesarean delivery, and 1 was lost to follow-up after 26 weeks of gestation. Conclusion UPMWA treatment for uterine fibroids and adenomyosis patients did not show significant effect on fertility. The impact on the continued pregnancy and pregnancy outcomes warrants further prospective study with larger sample size.

Key words： Uterine fibroids Adenomyosis Microwave ablation Natural pregnancy

收稿日期: 2014-10-27

基金资助:国家自然科学基金(81371562);北京市首都临床特色应用研究(Z131107002213144)

通讯作者: 张晶(zjbch@sina.com)

引用本文:

张冰松, 张晶, 韩治宇, 郝艳丽, 杨宇, 许长涛, 徐瑞芳, 马霞. 超声引导经皮微波消融治疗子宫良性病变后自然妊娠情况[J]. 中国生育健康杂志, 2015, 26(3): 202-206.
ZHANG Bingsong, ZHANG Jing, HAN Zhiyu, HAO Yanli, YANG Yu, XU Changtao, XU Ruifang, MA Xia. Natural pregnancy after ultrasound-guided percutaneous microwave ablation for uterine benign lesions. Chinese Journal of Reproductive Health, 2015, 26(3): 202-206.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2015/V26/I3/202

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