Application of oxytocin in ultrasound-guided percutaneous microwave ablation for treatment of hypervascular uterine fibroids: a preliminary report
Application of oxytocin in ultrasound-guided percutaneous microwave ablation for treatment of hypervascular uterine fibroids: a preliminary report
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DOI：
10.1080/02656736.2019.1639832
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发表时间：
2019-01-01
影响因子：
3.1
通讯作者：
Li, Yongjie
中科院分区：
文献类型：
--
作者：
Fu, Yajie;Feng, Qingliang;Li, Yongjie
目的：本研究评价微波消融（MWA）前给予催产素治疗富血供子宫肌瘤的效果。研究方法：32例患者共38个多血管子宫肌瘤（Adler血流3级），在超声引导下经皮MWA前20分钟接受静脉催产素输注（0.32 U/min）或不接受催产素（对照）。采用彩色多普勒超声（CDU）观察Adler血供分级及肌瘤体积的变化。所有患者均接受单针或双针定量消融，微波功率50 W（180 s）。未达到治疗目标的患者继续接受治疗。超声造影评估肌瘤坏死体积。消融率是治疗后MRI非增强肌瘤体积相对于治疗前肌瘤体积的百分比，手术后2天。结果如下：缩宫素给药后20 min，CDU显示肌瘤内血管明显减少，10例Adler血供由3级降至1级或0级，9例Adler血供由3级降至0级。肌瘤体积减少了2.12 +/-0.24%。催产素（对照）组的坏死体积为36.96 +/- 2.78 cm（3）（22.68 +/- 3.38 cm（3）），消融率为95.4 +/- 2.7%（85.7 +/- 3.3%; t = 12.68，8.866，p = 0.001，均为）。无严重并发症。结论：在多血管子宫肌瘤经皮MWA前静脉注射催产素可有效阻断肌瘤的供血血管，减少热沉效应，从而增加消融体积，提高局部治疗效果。
Objective: This study evaluated the effect of oxytocin administration prior to microwave ablation (MWA) of hypervascular uterine fibroids. Methods: Thirty-two patients with 38 hypervascular uterine fibroids (Adler blood flow grade 3) were equally apportioned to receive intravenous oxytocin infusion (0.32 U/min) 20 min before ultrasound-guided percutaneous MWA, or no oxytocin (control). Changes in Adler blood supply grade and myoma volume were observed via color Doppler ultrasonography (CDU). All patients underwent quantitative ablation with single or double needle and microwave power 50 W (180 s). Treatment continued for those who did not reach the therapeutic goal. The myoma necrotic volume was evaluated by contrast-enhanced ultrasound. Ablation rate was the percent of MRI nonenhanced myoma volume after treatment, relative to myoma volume before treatment, 2 days after surgery. Results: Twenty minutes after oxytocin administration, CDU showed significant decrease of blood vessels in myomas, and Adler blood supply decreased from grade 3 to grade 1 or grade 0 in 10 and 9 myomas, respectively. Myoma volumes were reduced by 2.12 +/- 0.24%. Necrotic volumes in the oxytocin (control) groups were 36.96 +/- 2.78 cm(3) (22.68 +/- 3.38 cm(3)) and ablation rates were 95.4 +/- 2.7% (85.7 +/- 3.3%; t = 12.68, 8.866, p = 0.001, both). No serious complication was noted. Conclusion: Intravenous oxytocin administered before percutaneous MWA of hypervascular uterine fibroids can effectively block the blood supply vessels of the myoma, reduce the heat sink effect, and thereby increase the ablation volume and improve the local therapeutic effect.