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高强度聚焦超声治疗子宫肌瘤初始学习曲线分析

ISSN号：1672-8475
期刊名称：《中国介入影像与治疗学》
时间：0
分类：R711.74[医药卫生—妇产科学;医药卫生—临床医学] R445.1[医药卫生—影像医学与核医学;医药卫生—诊断学;医药卫生—临床医学]
作者机构：[1]重庆医科大学生物医学工程学院省部共建国家重点实验室培育基地——重庆市超声医学工程重点实验室重庆市生物医学工程学重点实验室,重庆400016, [2]重庆医科大学附属第一医院超声消融治疗中心,重庆400042
相关基金：“十二五”国家科技支撑计划项目（2011BAI14B01）; 973项目（2011CB707900;2012CB722402）; 2011年高等学校博士学科点专向科研基金联合资助课题（20115503110014）

作者：张馨月[1], 陈锦云[1], 胡亮[1], 彭松[2], 陈文直[1], 王智彪[1]

关键词：高强度聚焦超声消融, 子宫肌瘤, 学习曲线, High intensity focused ultrasound ablation, Uterine fibroids, Learning curve

中文摘要：

目的探讨高强度聚焦超声（HIFU）治疗子宫肌瘤的学习曲线。方法前瞻性研究分析同一组3名接受超声消融培训的医师完成的最初60例HIFU治疗子宫肌瘤手术,按手术日期的先后,将60例患者的临床资料分为A、B和C组,每组20例。分析随手术例数的累积,治疗时间、照射时间、治疗强度、肌瘤消融率和患者不良反应是否存在学习曲线。结果 A组治疗时间明显长于C组（P=0.033）;A组照射时间明显长于B、C组（P=0.041、0.038）;三组治疗强度、消融率差异无统计学意义（P〉0.05）。全部病例无严重并发症发生,不良反应并未随着手术例数的增加有明显改变。治疗时间和照射时间存在学习曲线。结论 HIFU治疗子宫肌瘤存在学习曲线。在40例的操作经验后,治疗时间和照射时间明显缩短,消融率逐渐上升。培训期间,在指导老师监督下的操作是安全的。

英文摘要：

Objective To investigate the learning curve of high intensity focused ultrasound（HIFU）in treatment of uterine fibroids.Methods The first 60 consecutive HIFU procedures were performed by a team of 3surgeons.According to the operation date,all patients were divided into three groups：Group A,group B,group C.The learning curve was analyzed through evaluating treatment time,irradiation time,intensity,ablation rate and complications.Results The treatment time in group A was significantly longer than that in group C（P=0.033）;the irradiation time in group A obviously longer than that in group B and C（P=0.041,0.038）;no significant difference was found in intensity and ablation rate among 3groups（P〉0.05）.No serious events occurred.Complications had no obvious changes as the cases increased.Treatment time and irradiation time had learning curve.Conclusion There is a learning curve for the treatment of uterine fibroids with HIFU.After gaining experience in performing 40 cases,the treatment time and irradiation time are significantly reduced,and ablation rate is increased gradually.The operation can be performed safely during the learning period under the supervision.

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