中文摘要：

目的评价超声消融治疗弥漫型子宫腺肌病的安全性。方法对308例子宫腺肌病患者行高强度聚焦超声（HIFU）消融治疗,并于术后1天行MR检查,其中弥漫型子宫腺肌病184例（弥漫组）,局限型子宫腺肌病124例（局限组）。评估并比较两组的消融治疗效果、术中及术后不良反应及并发症情况。结果对308例患者均顺利完成治疗,消融发生率为99.35%（306/308）,弥漫组消融率[（25.47±13.29）%]低于局限组[（45.00±20.44）%],差异有统计学意义（P〈0.01）。HIFU术中弥漫组较局限组发生皮肤烫的风险增加1.80倍,局限组较弥漫组发生腹股沟区痛的风险增加2.12倍;术后局限组较弥漫组发生下肢感觉异常的风险增加6.28倍。308例中,65例（65/308,21.10%）因并发症接受简单治疗[国际放射治疗协会（SIR）-B级],其中弥漫组与局限组分别为39例（39/184,21.20%）和26例（26/124,20.97%）,差异无统计学意义（P〉0.05）。两组均未发生SIR-C~SIR-F级并发症。结论在严格控制消融范围的情况下,对弥漫型与局限型子宫腺肌病同样行HIFU治疗是安全、可行的。

英文摘要：

Objective To evaluate the safety of ultrasound ablation for diffuse adenomyosis.Methods A total of 308 patients with adenomyosis underwent the treatment of high-intensity focused ultrasound（HIFU）.And then MR examinations were performed in the first day after operation.Among them,there were 184 cases with diffuse adenomyosis（diffuse group）and 124 cases with focal adenomyosis（focal group）.The ablation results,intraoperative adverse effects and postoperative complications were recorded and compared between the two groups.Results For all of the patients,the procedure were completed successfully.The incidence of ablation was 99.35%（306/308）.The ablation ratio of diffuse group（[25.47±13.29]%）was lower than that of focal group（[45.00±20.44]%）.There was significant difference of ablation ratio between the two groups（P0.01）.The risk of intraoperative skin burn was 1.80 fold of diffuse group compared with focal group,while the risk of inguinal pain of focal group increased 2.12 fold compared with diffuse group.The risk of postoperative lower limbs paresthesia of focal group was 6.28 fold higher than that of diffuse group.There were 65 of 308cases（65/308,21.10%）accepted nominal therapy because of complications（[Society of Interventional Radiology,SIR]-B grade）.Among them,there were 39cases（39/184,21.20%）in diffuse group and 26cases（26/124,20.97%）in focal group,respectively.No significant difference was found between the two groups（P0.05）.Neither of the complained complications of SIR-C—SIR-F grade occurred in the two groups.Conclusion HIFU is safe and feasible for both diffuse and focal adenomyosis with strict control of the ablation range.