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目的探讨无水乙醇、生理盐水局部注射能否提高高强度聚焦超声能量沉积、提高子宫肌瘤治疗效率。方法将60例子宫肌瘤患者随机分为无水乙醇组、生理盐水组与对照组,每组20例。无水乙醇组、生理盐水组高强度聚焦超声消融前30 min在彩超引导下向肌瘤内注入无水乙醇、生理盐水各5 ml,对照组仅给予高强度聚焦超声治疗,比较3组的高强度聚焦超声消融能效因子(单位体积所需辐照能量)、体积消融率及并发症。结果无水乙醇组、生理盐水组及对照组高强度聚焦超声消融能效因子分别为:(4.88±1.51)J/mm~3、(8.71±1.73)J/mm~3、(13.57±2.21)J/mm~3,无水乙醇组<生理盐水组<对照组(P<0.05);体积消融率比较,差异无统计学意义(P>0.05);无水乙醇组较生理盐水组下腹疼痛的并发症增多(P<0.05),无水乙醇组、生理盐水组与对照组并发症比较,差异均无统计学意义(均P>0.05)。结论无水乙醇、生理盐水局部注射均能提高高强度聚焦超声能量沉积、提高子宫肌瘤治疗效率,且无水乙醇优于生理盐水作用,但无水乙醇所致的下腹疼痛并发症增多。
Objective To investigate whether ethanol injection and local injection of saline can improve the energy deposition of high intensity focused ultrasound and improve the treatment efficiency of uterine fibroids. Methods 60 cases of uterine fibroids were randomly divided into ethanol group, saline group and control group, 20 cases in each group. In the ethanol group and the saline group, high-intensity focused ultrasound 30 min before ablation was injected into the fibroids under the guidance of color Doppler ultrasonography, 5 ml each of normal saline. The control group was given high-intensity focused ultrasound only. The high Intensity focused ultrasound ablation efficacy factor (unit volume required for irradiation energy), volume ablation rate and complications. Results The energy efficiency factors of high intensity focused ultrasound ablation in ethanol group, saline group and control group were (4.88 ± 1.51) J / mm ~ 3, (8.71 ± 1.73) J / mm ~ 3, (13.57 ± 2.21) J / mm ~ 3, absolute alcohol group 0.05); anhydrous ethanol group than in the saline group, (P <0.05). There was no significant difference in the comparisons between the ethanol group, the saline group and the control group (all P> 0.05). Conclusions Both ethanol injection and saline injection can improve high-intensity focused ultrasound energy deposition and improve the treatment efficiency of uterine fibroids, and the effect of absolute ethanol is better than that of normal saline. However, complications of abdominal pain caused by absolute ethanol increase.