超声引导下高强度聚焦超声在妇产科疾病中的应用进展

doi:10.12280/gjfckx.20240211

摘要/Abstract

摘要：

近二十几年来，高强度聚焦超声（high intensity focused ultrasound，HIFU）发展迅速，其作为一种无探针、非电离辐射的微无创热消融技术，可将超声波聚焦于一点并产生瞬时高温以实现靶组织热变性、凝固性坏死和凋亡的治疗目的。HIFU分为经超声引导和经磁共振引导两类，其中超声引导下HIFU应用更为广泛，其在治疗子宫肌瘤、子宫腺肌病、剖宫产瘢痕妊娠、产后胎盘植入性疾病和宫颈妊娠等妇产科疾病中获得了大量的循证数据和临床经验，证实了其安全性和有效性，甚至在某些疾病的治疗中可替代一些传统的治疗方法。然而，超声引导下HIFU更多应用于病情平稳者，对于危急重症的抢救常需外科手术介入，正确认识并掌握其适应证和禁忌证，是精准治疗造福患者的必要条件。

关键词: 体外冲击波疗法, 超声检查, 平滑肌瘤, 子宫腺肌病, 剖宫产术, 瘢痕, 侵入性胎盘, 妊娠, 异位

Abstract:

In the past two decades, as a probe-free, non-ionizing radiation minimally invasive thermal ablation technology, high intensity focused ultrasound(HIFU) has developed rapidly. It can focus ultrasound waves on a single point and produce instantaneous high temperature to achieve the therapeutic purpose of thermal degeneration, coagulative necrosis, and apoptosis of target tissue. HIFU can be divided into two categories: ultrasound-guided and magnetic resonance-guided. Among them, ultrasound-guided HIFU is more widely used. It has obtained a large amount of evidence-based data and clinical experience in the treatment of gynecological and obstetric diseases such as uterine fibroids, uterine adenomyosis, cesarean scar pregnancy, postpartum placenta accreta spectrum, and cervical pregnancy, confirming its safety and effectiveness. It can even replace some traditional treatment methods in the treatment of certain diseases. However, ultrasound-guided HIFU is more commonly used in patients with stable conditions, and surgical intervention is often required for the rescue of critical and severe cases. Correct understanding and master of its indications and contraindications are necessary for precise treatment to benefit patients.

Key words: Extracorporeal shockwave therapy, Ultrasonography, Leiomyoma, Adenomyosis, Cesarean section, Scar, Placenta accreta, Pregnancy, ectopic

张岩, 胡梦颖, 王华, 董渠龙. 超声引导下高强度聚焦超声在妇产科疾病中的应用进展[J]. 国际妇产科学杂志, 2024, 51(4): 406-411.

ZHANG Yan, HU Meng-ying, WANG Hua, DONG Qu-long. Progress in The Application of Ultrasound-Guided High Intensity Focused Ultrasound in Gynecological and Obstetric Diseases[J]. Journal of International Obstetrics and Gynecology, 2024, 51(4): 406-411.

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