■探讨子宫肌瘤(UFs)患者行超声引导下聚焦超声消融(FUAS)术后腹部皮肤热损伤的可能因素。
■共有123例患者纳入损伤组。相比之下,246例无热损伤的患者被分配到非损伤组。使用单因素分析和多因素logistic回归分析探讨患者与治疗参数和损伤之间的关系。此外,使用Kruskal-WallisH.
■(1)腹部疤痕(p=.007,OR=2.187,95%CI:1.242-3.849)分析了影响热损伤程度的因素。腹壁厚度(p<.001,OR=1.042,95%CI:1.019-1.067),眼底肌瘤(p=0.038,OR=1.790,95%CI:1.033-3.100),具有高强度/混合T2加权成像(T2WI)信号的UF(p=0.022,OR=1.843,95%CI:1.091-3.115),平均超声处理功率(AP)(p=0.025,OR=1.021,95%CI:1.003-1.039),治疗时间(TT)(p<0.001,OR=1.017,95%CI:1.011-1.023)是热损伤的独立危险因素,而治疗体积(TV)(p=0.002,OR=0.775,95%CI:0.661-0.909)是损伤的保护因素。(2)根据热损伤程度细分为四组(A组:无皮肤损伤。B组:腹壁T2WI信号改变,C组:轻度皮肤损伤,D组:严重皮肤损伤),比较显示A组和D组的腹壁比B组和C组薄,差异有统计学意义(PAB<0.05,PAC<0.01,PDC<0.05,PDB<0.05);A组比D组稍厚,然而,无统计学差异。A组的超声处理时间(ST)与TV的比值最低(PAB,PAC,PAD均<0.05)。随着热损伤程度的上升,比例逐渐增加,然而,无统计学差异。
■根据我们有限的结果,得出以下结论。(1)腹部疤痕,腹壁厚度,眼底肌瘤,具有T2WI高强度/混合信号的UF,AP和TT是独立危险因素。(2)腹壁不宜太厚或太薄,因为两者都可能增加皮肤损伤的风险。(3)值得注意的是,当ST更长且超声处理区域更固定时,皮肤损伤的风险可能会大大增加.
UNASSIGNED: To investigate the factors which may cause thermal injury of abdominal skin in patients with uterine fibroids (UFs) who underwent ultrasound-guided focused ultrasound ablation surgery (FUAS).
UNASSIGNED: A total of 123 patients were enrolled in the injury group. In contrast, 246 patients without thermal injury were assigned to the non-injury group. The relationship between patient and treatment parameters and injury were explored using univariate analysis and multiple logistic regression analyses. In addition, the factors influencing the degree of thermal injury were analyzed using Kruskal-Wallis H.
UNASSIGNED: (1) Abdominal scars (p = .007, OR = 2.187, 95% CI: 1.242-3.849), abdominal wall thickness (p < .001, OR = 1.042, 95% CI: 1.019-1.067), fundus fibroids (p = .038, OR = 1.790, 95% CI: 1.033-3.100), UFs with hyperintense/mixed T2-weighted imaging (T2WI) signals (p = .022, OR = 1.843, 95% CI: 1.091-3.115), average sonication power (AP) (p = .025, OR = 1.021, 95% CI: 1.003-1.039), and treatment time (TT) (p < .001, OR = 1.017, 95% CI: 1.011-1.023) were independent risk factors for thermal injury, while treatment volume (TV) (p = .002, OR = 0.775, 95% CI: 0.661-0.909) was a protective factor for injury. (2) Four groups were subdivided according to the degree of thermal injury(Group A: without skin injury. Group B: with changed T2WI signal in the abdominal wall, Group C: mild skin injury, Group D: severe skin injury), comparison of each with every other showed that the abdominal wall in Groups A and D was thinner than Groups B and C, with statistically significant differences (PAB<0.05, PAC<0.01, PDC<0.05, PDB<0.05); Group A was slightly thicker than D, however, without statistical difference. The ratio of sonication time (ST) to TV in Group A was the lowest of all (PAB, PAC, PAD all < 0.05). And as the level of thermal injury rose, the ratio gradually increased, however, without statistical difference.
UNASSIGNED: Based on our limited results, the following conclusion was made. (1) Abdominal scars, abdominal wall thickness, fundus fibroids, UFs with T2WI hyperintense/mixed signals, AP and TT were independent risk factor. (2) Neither too thick nor too thin abdominal walls would be recommended, as both might increase the risk of skin injury. (3) Noticeably, the risk of skin injury might increase considerably when the ST was longer and the sonication area was more fixed.