Page 66 - 《应用声学》2025年第1期
P. 66

62                                                                                   2025 年 1 月


             像,即可在术中预测治疗是否会造成皮肤损伤的并                              [7] Dewhirst M W, Viglianti B L, Lora-Michiels M, et al.
             发,手术医生可以根据预测结果采取相应措施、改                                Basic principles of thermal dosimetry and thermal thresh-
                                                                   olds for tissue damage from hyperthermia[J]. International
             进手术方案,从而最大程度地避免皮肤损伤的发生。                               Journal of Hyperthermia, 2003, 19(3): 267–294.
                 虽然本研究从多种角度验证了次生焦点的存                             [8] Martin N A, Falder S. A review of the evidence for thresh-
                                                                   old of burn injury[J]. Burns, 2017, 43(8): 1624–1639.
             在,并发现它是造成皮肤及浅表组织烧伤的一个潜                              [9] Chen L, ter Haar G, Hill C R. Influence of ablated tissue
             在因素,但所采用的理论和仿真模型均比较简单,并                               on the formation of high-intensity focused ultrasound le-
                                                                   sions[J]. Ultrasound in Medicine & Biology, 1997, 23(6):
             且当前的实验设计也比较初步,没能完全考虑临床                                921–931.
             治疗过程中的复杂情形。因此,本研究所得结论还                             [10] Ji Y, Hu K, Zhang Y, et al. High-intensity focused ul-
                                                                   trasound (HIFU) treatment for uterine fibroids: A meta-
             只是定性层面,后续还需要继续设计更符合临床实                                analysis[J]. Archives of Gynecology and Obstetrics, 2017,
             际的验证性实验,并最终在临床中证实次生焦点造                                296(6): 1181–1188.
                                                                [11] Trumm C G, Stahl R, Clevert D A, et al. Magnetic res-
             成的伤害。                                                 onance imaging-guided focused ultrasound treatment of
                                                                   symptomatic uterine fibroids[J]. Investigative Radiology,
             4 结论                                                  2013, 48(6): 359–365.
                                                                [12] Chen J, Li Y, Wang Z, et al.  Evaluation of high-
                                                                   intensity focused ultrasound ablation for uterine fibroids:
                 本研究从声传播的角度揭示利用HIFU 治疗腹
                                                                   An IDEAL prospective exploration study[J]. BJOG: An
             部子宫肌瘤时,腹部脂肪-肌肉界面反射可以形成次                               International Journal of Obstetrics & Gynaecology, 2018,
                                                                   125(3): 354–364.
             生焦点,该次生焦点能够导致组织温度升高至50 C
                                                        ◦
                                                                [13] Kennedy J E. High-intensity focused ultrasound in the
             甚至更高,这是临床中皮肤及浅表组织烧伤的原因                                treatment of solid tumours[J]. Nature Reviews Cancer,
                                                                   2005, 5(4): 321–327.
             之一。初步研究还显示,在声场中多层组织界面与
                                                                [14] 金松花, 宋进学. 高强度聚焦超声治疗子宫肌瘤所致皮肤损伤
             实际靶点的位置关系对次生焦点影响较大,并呈现                                的观察 [J]. 临床超声医学杂志, 2014, 16(10): 717–718.
                                                                   Jin Songhua, Song Jinxue. Observation of skin lesions
             一定规律。本研究结果有助于在 HIFU 手术中预测
                                                                   caused by the treatment of uterine fibroids by high inten-
             并预防皮肤烧伤的发生,对进一步提高利用 HIFU                              sity focused ultrasound[J]. Journal of Clinical Ultrasound
             治疗子宫肌瘤的安全性具有理论指导意义。                                   in Medicine, 2014, 16(10): 717–718.
                                                                [15] Sridhar D, Kohi M. Updates on MR-guided focused ul-
                                                                   trasound for symptomatic uterine fibroids[J]. Seminars in
                            参 考     文   献                          Interventional Radiology, 2018, 35(1): 17–22.
                                                                [16] Yang C W, Yang E, Yeh M J, et al. Thermal injury to
                                                                   skin and abdominal wall structures during HIFU ablation
              [1] ter Haar G, Coussios C. High intensity focused ultrasound:
                                                                   of uterine fibroids: Three cases[J]. Chung Shan Medical
                 Physical principles and devices[J]. International Journal of
                                                                   Journal, 2022, 33: 151–156.
                 Hyperthermia, 2007, 23(2): 89–104.
                                                                [17] 杨武威, 祝宝让, 李静, 等. 超声消融治疗子宫肌瘤的近期并
              [2] Izadifar Z, Babyn P, Chapman D. Mechanical and bio-
                                                                   发症及其影响因素分析 [J]. 中华妇产科杂志, 2010, 45(12):
                 logical effects of ultrasound: A review of present knowl-  913–916.
                 edge[J]. Ultrasound in Medicine & Biology, 2017, 43(6):
                                                                   Yang Wuwei, Zhu Baorang, Li Jing, et al. Analysis of com-
                 1085–1104.                                        plications of high intensity focused ultrasound in treat-
              [3] Ning G, Zhang X, Zhang Q, et al. Real-time and multi-  ment of uterine leiomyoma[J]. Chinese Journal of Obstet-
                 modality image-guided intelligent HIFU therapy for uter-  rics and Gynecology, 2010, 45(12): 913–916.
                 ine fibroid[J]. Theranostics, 2020, 10(10): 4676–4693.  [18] Chen J, Chen W, Zhang L, et al. Safety of ultrasound-
              [4] Zhang L, Rao F, Setzen R. High intensity focused ultra-  guided ultrasound ablation for uterine fibroids and adeno-
                 sound for the treatment of adenomyosis: Selection criteria,  myosis: A review of 9988 cases[J]. Ultrasonics Sonochem-
                 efficacy, safety and fertility[J]. Acta Obstetricia et Gyne-  istry, 2015, 27: 671–676.
                 cologica Scandinavica, 2017, 96(6): 707–714.   [19] Fan X, Hynynen K. The effect of wave reflection and re-
              [5] Gizzo S, Saccardi C, Patrelli T S, et al.  Mag-  fraction at soft tissue interfaces during ultrasound hyper-
                 netic resonance-guided focused ultrasound myomectomy:  thermia treatments[J]. The Journal of the Acoustical So-
                 Safety, efficacy, subsequent fertility and quality-of-life  ciety of America, 1992, 91(3): 1727–1736.
                 improvements, a systematic review[J]. Reproductive Sci-  [20] 杜功焕, 朱哲明, 龚秀芬. 声学基础 [M]. 第 2 版. 南京: 南京
                 ences, 2014, 21(4): 465–476.                      大学, 2001: 206–211.
              [6] Yin N, Hu L, Xiao Z B, et al. Factors influencing ther-  [21] Shieh J, Chen S R, Chen G S, et al. Acrylic acid con-
                 mal injury to skin and abdominal wall structures in HIFU  trolled reusable temperature-sensitive hydrogel phantoms
                 ablation of uterine fibroids[J]. International Journal of Hy-  for thermal ablation therapy[J]. Applied Thermal Engi-
                 perthermia, 2018, 34(8): 1298–1303.               neering, 2014, 62(2): 322–329.
   61   62   63   64   65   66   67   68   69   70   71