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目的探讨经皮微波消融联合无水乙醇瘤周注射治疗均径>5cm症状性子宫肌瘤的临床疗效。方法 54例单发的子宫肌瘤,长径5.1~8.8cm,平均(6.3±2.41)cm,随机分成两组,对照组28例,行常规的微波消融治疗;研究组26例,在常规子宫肌瘤微波消融基础上行瘤周滋养动脉无水乙醇注射治疗;术后随访3个月,观察比较两组患者治疗效果。结果治疗结束后即刻行静脉超声造影,研究组显示1例70%无增强,1例50%无增强,24例无造影剂充填,消融有效率为92.23%(24/26)。对照组3例约45%无增强,1例50%无增强,1例70%无增强,均行第二次凝固治疗,致结节完全无增强,有效率为82.14%(23/28)。两组相比有统计学意义(P<0.05)。结论经皮微波消融联合无水乙醇瘤周注射,可提高子宫肌瘤的有效消融率。
Objective To investigate the clinical effect of percutaneous microwave ablation combined with percutaneous ethanol injection in the treatment of symptomatic uterine fibroids with average diameter> 5cm. Methods Totally 54 cases of uterine fibroids with long diameter of 5.1 ~ 8.8cm (average 6.3 ± 2.41cm) were randomly divided into two groups, control group (n = 28) and conventional microwave ablation. The study group (n = 26) On the basis of microwave ablation of fibroids, peritubular nourishing artery with ethanol injection was performed. The patients were followed up for 3 months and the therapeutic effect was observed and compared between the two groups. Results Intravenous ultrasonography was performed immediately after treatment. The study group showed no enhancement in 70%, no enhancement in 50%, and contrast-free filling in 24 patients. The effective rate of ablation was 92.23% (24/26). The control group, about 45% of 3 cases without enhancement, 1 case of 50% without enhancement, 1 case of 70% without enhancement, were the second coagulation therapy, resulting in no enhancement of nodules, the effective rate was 82.14% (23/28). The two groups were statistically significant (P <0.05). Conclusion percutaneous microwave ablation combined with peritoneal injection of peritumoral can increase the effective rate of uterine fibroids ablation.