超声引导下微创治疗子宫肌瘤

目前正式报道的超声引导下微创治疗子宫肌瘤的方法有两大类：（1）局部热消融治疗：在超声准确定位监视下或超声引导下将物理高温导入子宫肌瘤结节内，将肌瘤组织热凝固灭活，包括高强度聚焦超声、微波消融及射频消融。（2）在超声引导下向肌瘤内注入凝固剂或化疗药物灭活肌瘤组织。各种局部热消融治疗方法在消融范围内均可将肌瘤细胞有效灭活，疗效可靠，治疗后肌瘤可有效缩小、临床症状明显改善或消失，对正常生理功能影响很小或无明显影响。各种方法中，高强度聚焦超声无创伤，但治疗所需时间较长；微波或射频热效率高，治疗耗时短，但需肌瘤穿刺。肌瘤内注入凝固剂或药物操作方便，但由于药物弥散的因素适合3cm以下肌瘤的治疗。超声引导微创治疗子宫肌瘤创伤小、保留子宫，在有效使肌瘤缩小并控制临床症状的同时对患者的生理功能无影响或影响很小，并发症少，术后恢复快，有望成为治疗子宫肌瘤的主要方法之一。但治疗前应排除子宫恶性病变，并严格掌握适应证。

Minimum lnterventional Treatment for Uterus Leiomyoma Under US--guidance

According to the published articles, the methods of MITUM under USG can be classified into 2 category, （1）Location thermal ablation： The uterus leiomyoma is coagulated into necrosis by physical high temperature that is lead into the leiornyoma nodule under ultrasound nicely guidance and surveillance. This method includes high intensity focused ultrasound HIFU, microwave ablation MW and radiofrequency ablation RA. （2）To kill the leiomyoma cells by injecting the co agulating agency ICA or chemotherapy medicines ICM into the leiomyoma nodule through the nodule puncture under USG. The leiomyoma cells can be killed effectively by the methods that has mentioned above the leiomyoma shrink obviously after treatment, the clinical symptoms are improved obviously or disappear, moreover the normal physiological functions of patient can be not infected or tine. Among the methods, HIFU is nontrauma however, takes time; MW or RA have a high efficiency and need short time but the myona puncture is need. It is convenient to operate for ICA or ICM into the leiomyoma, and it is suitable only to those nodule largest diameter less than 3cm, because the dispersion of medicine is not uniformity. MITUM under USG has minimum hurt,does not need hysterectomy,the leiomyoma can be shrunk effectively and the clinical symptoms can be improved obviously with no or little side effect. MITUM under USG is one of optional method for the treatment of patient with leiomyorna and want to preserving her uterus.