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目的探讨超声引导自凝刀射频消融(RFA)联合聚桂醇硬化治疗子宫肌瘤的疗效。方法超声引导下自凝刀RFA症状性子宫肌瘤患者102例,共114个肌瘤。治疗后3个月复查病灶,排除无血流及造影剂灌注的病例,将剩余22个子宫肌瘤随机平均分成两组,分别行超声引导下RFA补充治疗及聚桂醇硬化治疗。结果初次RFA后3个月与治疗前相比,114个子宫肌瘤血流分级明显下降(P<0.05)。需补充治疗的22个子宫肌瘤中,浆膜下肌瘤近浆膜侧周边、内部及近黏膜侧内部血流量明显多于肌壁间与黏膜下肌瘤。补充消融组完全消融率63.6%(7/11),硬化治疗组完全硬化率100%(11/11),两组相比,差异有统计学意义(P<0.05)。结论超声引导聚桂醇硬化辅助自凝刀RFA子宫肌瘤,较单一RFA更为安全。针对近浆膜侧血流丰富的浆膜下肌瘤,采取聚桂醇硬化作为补充治疗在临床上实用价值更大。
Objective To investigate the curative effect of ultrasound-guided self-coagulating knife radiofrequency ablation (RFA) combined with laurel sclerotherapy in treating uterine fibroids. Methods 102 cases of RFA symptomatic uterine fibroids were scored by self-coagulation knife guided by ultrasound. There were 114 fibroids in total. Three months after treatment, the lesion was examined, and the cases without blood flow and contrast agent were excluded. The remaining 22 uterine fibroids were randomly divided into two groups, and under the guidance of ultrasound-guided RFA supplementation and lauryl alcohol sclerotherapy respectively. Results The blood flow classification of 114 uterine fibroids was significantly decreased at 3 months after the first RFA compared with that before treatment (P <0.05). Need to add the treatment of 22 uterine fibroids, subserosal fibroids near the serosal side, internal and near mucosal side of the internal blood flow was significantly more than between the muscular wall and submucosal fibroids. Complete ablation rate of ablation group was 63.6% (7/11), and sclerosis group was 100% (11/11). There was significant difference between the two groups (P <0.05). Conclusion Ultrasound-guided lauryl alcohol sclerosis assisted self-coagulation knife RFA uterine fibroids, more than a single RFA more secure. For the subserosal blood flow rich subserosal fibroids, to take lauryl alcohol sclerosis as a supplementary treatment in the clinical practical value.