Therapy Of Ultrasound-guided Percutaneous Microwave Ablation Of Uterine Fibroids

Objective:To evaluate the safety and effectiveness of ultrasound-guided percutaneous microwave ablation in the treatment of uterine fibroids,and to provide a basis for clinical treatment decisions.Methods:20 cases of uterine fibroids(33uterine tumors)who came to our hospital from May 2018 to May 2019 were selected.Patients underwent ultrasound-guided percutaneous microwave ablation therapy.In the study,we strictly controlled the dose-effect relationship of microwave ablation needles.Gray-scale ultrasound was monitored in three-dimensional space in real-time.Contrast-enhanced Ultrasound clearly determined whether the target ablation range was reached and safe and accurate ablation was achieved.After treatment,they were reviewed at 3 months,6 months,and 12 months.Ultrasound two-dimensional,color Doppler and contrast examinations were performed to observe and record whether there were complications,clinical symptom relief,and ultrasound performance(including tumor size and Blood supply,etc.).Results:1.Clinical manifestations before and after ablation treatment:3.Clinical manifestations before and after ablation treatment:before operation:8 cases of anemia(44.4%),heme(97.1±7.3)g/L,10 cases(50.0%)more menstruation,4 cases(22.2%)prolonged period,dysmenorrhea 5 cases(22.2%),10 cases of compression symptoms(50.0%);3 months after operation,3 cases of anemia(16.7%),heme(108.8 ± 6.6)g/L,1 case of extra menstruation(5.6%),1 case(5.6%)prolonged menstrual period,2 cases(11.1%)dysmenorrhea;3 cases(15%)complained of compression symptoms;6 months after operation:1 case(5.6%)prolonged menstrual period,1 case(5.6%)dysmenorrhea,12 months after operation:1 case(5.6%)prolonged menstrual period.2.Analysis of the occurrence of adverse reactions during treatment of uterine fibroids:In this study,the postoperative adverse reaction was SIR A-B grade,and no serious complications occurred in all patients:8 cases(38.9%)with mild abdominal pain,5 cases(25%)with nausea and vomiting,4 cases(20%)with increased blood pressure,and elevated body temperature(37.5??38.5?)2 cases(11.1%)were relieved after follow-up observation or symptomatic support treatment.3.Comparison of tumor volume changes and effective analysis before and after ablation:At 3 months,6 months,and 12 months after ablation treatment,the average volume reduction rates of uterine fibroids were(62.07 ± 11.59)%,(70.13 ±9.50)%,and(85.32±7.19)%.The volume was significantly reduced(P<0.05).4.Gray-scale Acoustic image performance after ablation treatment:3?6 months after ablation treatment:The gray-scale acoustic image shows a high echo with a clear boundary or a heterogeneous mixed echo,in which multiple focus-like echoless areas of different sizes can be seen;9?12 months afterablation treatment:The overall echo of the ablation treatment area is lower than before,the number of non-echo areas is reduced,and the scope is reduced;Hyperechoic needle track has been shown during postoperation.5.CDFI performance after ablation treatment:CDFI showed 3?12 months after ablation treatment:no obvious blood flow signal in the lesion ablation area,The blood flow scores of 23 tumors(80.8%)before ablation treatment were grade???;the blood flow scores of 33 tumors(100%)from3-6 month after ablation treatment were all grade 0??.6.performance after ablation treatment:contrast-enhanced ultrasound showed ablation treatment area had no contrast agent perfusion.Conclusion:Ultrasound-guided percutaneous microwave ablation is a safe and effective minimally invasive surgery for uterine fibroids.This method has obvious clinical symptom improvement,postoperative tumor body is significantly smaller than before,reliable effect,few complications,and can maintain a state of no blood supply for a long time.