中文摘要：

目的探讨高强度聚焦超声（HIFU）治疗子宫肌瘤前辅助应用丙酸睾丸酮的临床价值。方法将60例子宫肌瘤患者随机分为两组,HIFU治疗前联合丙酸睾丸酮治疗（研究组）或仅接受单纯HIFU治疗（对照组）。观察并记录HIFU治疗参数指标、发生凝固性坏死时的声像图灰阶改变、术中不良反应及术后并发症,测量并计算肌瘤内无灌注区体积、消融率、治疗后6个月子宫体积缩小率及肌瘤体积缩小率,并进行统计学分析。结果两组间HIFU治疗的治疗功率、治疗时间、辐照时间、治疗强度、治疗剂量差异均无统计学意义（P均〉0.05）。研究组出现团状强回声的比例[53.33%（16/30）]高于对照组[26.67%（8/30）,2χ=4.444,P=0.035]。两组间出现团状强回声的辐照时间、治疗过程中患者不良反应、治疗后肌瘤内无灌注区体积、消融率、治疗后6个月子宫体积缩小率及肌瘤体积缩小率差异均无统计学意义（P均〉0.05）。两组中HIFU治疗后并发症患者均经对症治疗后好转,无严重并发症发生。结论 HIFU治疗子宫肌瘤前辅助应用丙酸睾丸酮并不能有效提高消融率及治疗后肌瘤体积缩小率,但在一定程度上有利于治疗中团状强回声的出现。

英文摘要：

Objective To investigate the clinical value of testosterone propionate as an auxiliary application before high intensity focused ultrasound（HIFU）treatment in uterine leiomyomas.Methods Totally 60 patients with uterine leiomyomas treated by HIFU were randomly divided into two groups.Testosterone propionate before HIFU treatment was performed in study group,while simple HIFU treatment was performed in control group.The parameters of HIFU treatment,change of echo intensity when coagulation necrosis occured,occurrence of adverse reaction and postoperative complications were observed and collected.The statistical data of non-perfusion volume,ablation proportion,the reduction ratio of uterus and leiomyoma volumes at 6months after treatment were measured and calculated.The statistical analysis was done.Results There was no statistical difference of the HIFU power,treatment time,irradiation time,treatment intensity and therapeutic doses between the two groups（all P〉0.05）.The ratio of hyperecho appearing in the study group（53.33%[16/30]）was higher than that in control group（26.67%[8/30]）,χ2=4.444,P=0.035].No statistical differences of the irradiation time of hyperecho appearing,occurrence of adverse reaction,non-perfusion volume,ablation proportion,and reduction ratio of uterus and leiomyoma volumes at 6months after the treatment was found between the two groups（all P〉0.05）.The postoperative complications were remitted after expectant treatment.No serious complication occurred.Conclusion Testosterone propionate can not increase the ablation proportion or the reduction ratio of leiomyomas volume after HIFU treatment.But it is conducive to the appearing of hyperecho during the treatment.