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中华妇幼临床医学杂志(电子版)

中华妇幼临床医学杂志(电子版) ›› 2012, Vol. 08 ›› Issue (04) : 468 -470. doi: 10.3877/cma.j.issn.1673-5250.2012.04.019

所属专题： 文献；

论著

高强度聚焦超声治疗子宫肌瘤对卵巢功能的影响
陈衡1,*,*(), 黄耀1, 张卫星1, 李淑杏1, 陈小珍1   
  1. 1. 518033　广东深圳，广东医学院附属深圳福田区人民医院妇产科
  • 收稿日期:2012-02-02 修回日期:2012-07-05 出版日期:2012-08-01
  • 通信作者: 陈衡

Study of Influence on Ovarian Function by HIFU and Surgical Treatment for Uterine Fibroids

Heng CHEN1(), Yao HUANG1, Wei-xing ZHANG1, Shu-xing LI1, Xiao-zhen CHEN1   

  1. 1. Department of Obstetrics and Gynecology, Futian People's Hospital of Shenzhen, Guangdong Medical College, Shenzhen 518033, Guangdong Province, China
  • Received:2012-02-02 Revised:2012-07-05 Published:2012-08-01
  • Corresponding author: Heng CHEN
  • About author:
    (Corresponding author: Chen Heng, Email: )
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陈衡, 黄耀, 张卫星, 李淑杏, 陈小珍. 高强度聚焦超声治疗子宫肌瘤对卵巢功能的影响[J]. 中华妇幼临床医学杂志(电子版), 2012, 08(04): 468-470.

Heng CHEN, Yao HUANG, Wei-xing ZHANG, Shu-xing LI, Xiao-zhen CHEN. Study of Influence on Ovarian Function by HIFU and Surgical Treatment for Uterine Fibroids[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2012, 08(04): 468-470.

目的

探讨高强度聚焦超声(HIFU)治疗子宫肌瘤对卵巢功能的影响。

方法

选择2008年1月至2010年12月在本院就诊的90例子宫肌瘤患者为研究对象，按照治疗方式不同将其分为HIFU组(n＝30，HIFU治疗),肌瘤剔除组(n＝30，子宫肌瘤剔除术)和全子宫切除组(n＝30，全子宫切除术)。测定并分析3组患者术前及术后6个月血清卵泡刺激素(FSH)、黄体生成素(LH)和雌二醇(E2)水平变化(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该委员会批准，并与之签署临床研究知情同意书)。3组患者年龄、临床症状及肌瘤类别方面比较，差异无统计学意义(P>0.05)。

结果

HIFU组和肌瘤剔除组患者术前与术后6个月血清FSH，LH，E2比较，差异无统计学意义(P>0.05)。全子宫切除组患者术后6个月血清FSH，LH明显升高，E2明显下降，与术前相比，差异有统计学意义(P<0.05)。HIFU组与全子宫切除组术后6个月激素水平变化比较，差异有统计学意义(P<0.05)。

结论

HIFU治疗育龄期子宫肌瘤患者对卵巢功能无明显影响。

关键词: 高强度聚焦超声, 子宫肌瘤, 手术, 卵巢功能
Objective

To explore the influence on ovarian function by HIFU, myomectomy, and hysterectomy for uterine fibroids.

Methods

From January 2008 to December 2010, 90 women with uterine fibroids were included in the study, and divided into high intensity focused ultrasound (HIFU)group(n=30), myomectomy group(n=30) and hysterectomy group(n=30) according to treatment method. Measure and compare the serum follicle-stimulating hormone (FSH), luteinizing hormone(LH)and estradiol hormone(E2) level changes at 6 months before and after treatment.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Futian People's Hospital of Shenzhen. Informed consent was obtained from each patient. There has no significant differences between ages, clinical symptom and clinical classification among three groups(P>0.05).

Results

No significant difference was found in hormone levels between preoperative and 6 months after treatment in HIFU group and myomectomy group. 6 months after hysterectomy, FSH, LH increased and E2 decreased which were significant differences compared to preoperative(P<0.05). There had significant differences of hormone level change between HIFU group and hysterectomy group in 6 months after treatment.

Conclusions

HIFU treatment for childbearing age women with uterine fibroids does not influence the ovarian function.

Key words: high intensity focused ultrasound, uterine fibroids, surgery, ovarian function
表1 3组患者一般情况比较[n(%)]
Table 1 Comparison of general condition among three groups[n(%)]
组别 n 平均年龄(岁) 临床症状 肌瘤类别
子宫出血 下腹胀痛 肌壁间肌瘤 浆膜下肌瘤 黏膜下肌瘤
HIFU组 30 38.8 21(70.0) 20(66.7) 25(83.3) 3(10.0) 2(6.7)
肌瘤剔除组 30 38.4 20(66.7) 20(66.7) 24(80.0) 5(16.7) 1(3.3)
全子宫切除组 30 39.1 22(73.3) 19(63.3) 23(76.7) 5(16.7) 2(6.7)
P ? ? >0.05 >0.05
表2 3组患者术前及术后6个月激素水平变化比较(±s)
Table 2 Comparison of serum hormone levels among three groups 6 months after treatment(±s)
组别 n FSH (mIU/mL) LH(mIU/mL) E2(pg/mL)
术前 术后6个月 P 术前 术后6个月 P 术前 术后6个月 P
HIFU组 30 7.85±2.21 7.92±2.34 >0.05 5.50±2.11 5.56±2.22 >0.05 102.20±20.10 103.60±22.70 >0.05
肌瘤剔除组 30 7.82±2.37 7.93±2.53 >0.05 5.47±2.31 5.83±2.42 >0.05 103.40±23.30 98.30±21.40 >0.05
全子宫切除组 30 7.93±2.25 16.23±4.25 <0.05 5.62±2.27 9.22±2.69 <0.05 101.60±22.70 58.00±16.20 <0.05
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