高强度聚焦超声治疗胎盘植入中的安全性及有效性评估

Clinical safety and efficacy of high-intensity focused ultrasound（HIFU） in the treatment of placenta accreta

摘要:

目的：通过观察高强度聚焦超声（high-intensity focused ultrasound，HIFU）治疗胎盘植入患者的临床疗效及不良反应，评价超声消融治疗胎盘植入中的安全性及有效性。方法：将15例诊断为胎盘植入的患者进行高强度聚焦超声治疗，于治疗前后分别行六氟化硫微泡造影，以评价胎盘植入部位血供情况，术后1周用彩色多普勒超声评价植入胎盘面积变化、血HCG水平及月经恢复情况。结果：15例患者术后立即行六氟化硫微泡造影，其中14例患者未见明显血流信号，1例仍有部分血流信号，即刻治疗有效率达93.3%，治疗后1周有效率达100%，治疗后3天14例血人体绒膜促性腺激素水平明显降低，1例下降不明显；另外9例月经来潮，其经期、经量、周期较孕前无统计学差别。结论：HIFU能安全有效治疗胎盘植入。

Abstract:

Objective：To evaluate the clinical safety and efficacy of high -intensity focused ultrasound（HIFU） in the treatment of pla－centa accreta． Methods：Fifteen patients with placenta accreta were treated with the HIFU. The blood-perfused area of placenta acc－reta was observed through sulphur hexafluoride microbubbles；the placenta accreta volume and the blood β-human chorionic go－nadotropin（HCG）as well as the time of return of normal menses were evaluated by color Doppler ultrasound. Results：After the treat－ment of HIFU，the blood-perfused area of fourteen cases was disappeared. One case still had blood perfusion，the effective rate of im－mediate treatment was 93.3% and the effective rate of one-week treatment was 100%. The bloodβ-HCG of fourteen cases were sig－nificantly reduced after treatment. In addition，nine cases resumed normal menstruation. Conclusion：HIFU as a new treatment method for placenta accreta is safe and effective．