摘要
目的评估磁共振引导下聚焦超声(MRgFUS)治疗子宫肌瘤后发生即刻子宫内膜损伤和3个月后内膜损伤的影响因素。方法回顾性分析2016年8月至2020年10月在北京协和医院妇科筛查、北京万柳美中宜和妇儿医院行MRgFUS的66例子宫肌瘤患者的临床资料,比较治疗后即刻内膜损伤组与未损伤组之间的差异。采用逐步回归法分析治疗后即刻和治疗后3个月子宫内膜损伤的相关因素,Logistic多元回归探讨年龄、治疗前体积、子宫肌瘤是否多发、国际妇产科联盟(FIGO)分型、T2WI信号强度、治疗耗时是否是治疗后即刻子宫内膜损伤和3个月后内膜损伤的影响因素。结果66例患者中,41例(62.1%)治疗后即刻子宫内膜无损伤,4例(6.1%)为1级损伤,5例(7.6%)为2级损伤,16例(24.2%)为3级损伤;49例(74.2%)治疗后3个月内无损伤,5例(7.6%)为1级损伤,2例(3.0%)为2级损伤,10例(15.2%)为3级损伤。逐步回归分析结果显示,子宫肌瘤FIGO分型与治疗后即刻子宫内膜损伤(B=-0.121,SE=0.045,β=-0.326,t=-2.670,P=0.010)和3个月后子宫内膜损伤(B=-0.125,SE=0.042,β=-0.375,t=-2.989,P=0.004)显著相关。Logistic多元回归分析结果显示,FIGO分型是治疗后即刻子宫内膜损伤[OR=0.518(0.307~0.873),P=0.014]和3个月子宫内膜损伤[OR=0.456(0.253~0.824),P=0.009]的独立影响因素。结论MRgFUS治疗子宫肌瘤引起的子宫内膜损伤可控,FIGO分型是治疗后即刻子宫内膜损伤与3个月后子宫内膜损伤的独立影响因素。
Objective To explore the risk factors for incident endometrial injury and 3-month endometrial injury after magnetic resonance-guided focused ultrasound(MRgFUS)ablation of uterine fibroids(UF).Methods UF patients who were diagnosed in Peking Union Medical College Hospital and underwent MRgFUS ablation in Amcare Women’s and Children’s Hospital from August 2016 to October 2020 were retrospectively enrolled in this study.Clinical data of 66 UF patients were collected and compared between endometrial injury group and non-injury group.Stepwise regression was employed to determine the risk factors for the incident endometrial injury and 3-month endometrial injury.Multivariate logistic regression analysis was performed to explore the relationship of endometrial injury with age,pre-ablation tumor size,multiple UF,International Federation of Gynecology and Obstetrics(FIGO)classification,T2WI signal intensity,and treatment time.Results In terms of incident endometrial injury,the 66 patients included 41(62.1%)cases with no injury,4 cases(6.1%)with grade 1 injury,5 cases(7.6%)with grade 2 injury,and 16 cases(24.2%)with grade 3 injury.In terms of 3-month endometrial injury,the 66 patients included 49 cases(74.2%)with no injury,5 cases(7.6%)with grade 1 injury,2 cases(3.0%)with grade 2 injury,and 10 cases(15.2%)with grade 3 injury.Stepwise regression analysis indicated that FIGO classification was significantly associated with incident endometrial injury(B=-0.121,SE=0.045,β=-0.326,t=-2.670,P=0.010)and 3-month endometrial injury(B=-0.125,SE=0.042,β=-0.375,t=-2.989,P=0.004).Multivariate logistic regression analysis showed that FIGO classification was an independent risk factor for incident endometrial injury[OR=0.518(0.307-0.873),P=0.014]and 3-month endometrial injury[OR=0.456(0.253-0.824),P=0.009].Conclusions Endometrial injury could be controlled after MRgFUS ablation of UF and recover to some extent after 3 months.FIGO classification was an independent risk factor for both incident and 3-month endometrial injury.
作者
叶锦棠
石海峰
苏佰燕
周慷
苏蒙
张羽
张桂芳
金征宇
YE Jintang;SHI Haifeng;SU Baiyan;ZHOU Kang;SU Meng;ZHANG Yu;ZHANG Guifang;JIN Zhengyu(MR Department,Amcare Women’s and Children’s Hospital,Beijing 100089,China;Department of Radiology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Department of Gynecology and Obstetrics,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Department of Epidemiology,the Key laboratory of Geriatrics,Beijing Institute of Geriatrics,National Center of Gerontology,Beijing Hospital,Beijing 100730,China)
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2021年第3期414-420,共7页
Acta Academiae Medicinae Sinicae
关键词
子宫肌瘤
子宫内膜损伤
磁共振
聚焦超声
uterine fibroids
endometrial injury
magnetic resonance
focused ultrasound
