高强度聚焦超声(HIFU)治疗子宫肌瘤1例

Yoana G. Ivanova, M. Gohar, E. Gyokova, A. Yordanov, D. Dimitrov
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摘要

子宫肌瘤是育龄妇女最常见的良性子宫肿瘤。她们可以表现出不同的症状,包括月经过多、痉挛下腹痛、腹胀、尿/肠症状、点滴和不孕症。治疗可以是内科和外科。其他选择包括子宫动脉栓塞和高强度聚焦超声(HIFU)的非侵入性治疗。我们提出的情况下,一个32岁的妇女月经过多和严重的盆腔疼痛。超声检查显示子宫壁内肌瘤,尺寸为93x98x87 mm。患者签署了HIFU子宫肌瘤消融的知情同意书。手术三个月后,核磁共振扫描显示肌瘤缩小到原来大小的75%,尺寸为32x35x29。六个月后,她怀孕了,并在怀孕38周时通过剖腹产生下了一个健康的婴儿,当时子宫肌瘤的大小为2厘米。HIFU是手术治疗的替代方案,对希望将来怀孕的妇女非常有益。保留子宫肌瘤患者未来怀孕的选择只是其好处之一,可能是这些妇女的关键解决方案。HIFU治疗子宫肌瘤是一种创新的方法。应该鼓励:它被广泛采用在类似的情况下,它已经积极影响治疗子宫肌瘤。
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Use of High-Intensity Focused Ultrasound (HIFU) in Treating Uterine Fibroids: A Case Report
Summary Uterine fibroids are the most common benign uterine tumours in women of reproductive age. They can present with different symptoms, including menorrhagia, cramping lower abdominal pain, bloating, urinary/bowel symptoms, spotting, and infertility. Management could be medical and surgical. Other options include uterine artery embolization and non-invasive treatment with high-intensity focused ultrasound (HIFU). We present a case of a 32-year-old woman with menorrhagia and severe pelvic pain. Ultrasound examination revealed an intramural myoma measuring 93x98x87 mm. The patient signed informed consent for HIFU ablation of the fibroid. Three months after the procedure, an MRI scan showed the fibroid had shrunk to 75% of its original size with dimensions 32x35x29. After six months, she became pregnant and gave birth to a healthy infant at 38-weeks gestation with caesarean section, at which point the fibroid measured 2 cm. HIFU is an alternative to surgical therapies and is highly beneficial in women wishing for future pregnancies. Preserving the option for future pregnancies in patients with uterine fibroids is only one of its benefits and might be the key solution for these women. HIFU treatment of uterine fibroids is an innovative approach. It should be encouraged: it is widely adopted in similar cases where it has positively impacted the treatment of uterine fibroids.
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