治療子宮肌瘤免開刀！標靶音波刀新技術 無傷口隔天即可出院
2022-09-06 記者陳宜琳/嘉義報導
大林慈濟醫院引標靶音波刀，提供子宮肌瘤及子宮肌腺症患者開刀以外的選擇（圖：大林慈濟醫院提供）
一名34歲黃女士，因長期經血過多而貧血、腹痛、血紅素偏低，至大林慈濟醫院婦產科就診，醫師檢查發現數顆大小不等的子宮肌瘤，經標靶音波刀治療後，已大幅改善症狀，恢復正常生活。
婦產科陳建翰醫師表示，子宮肌瘤常見症狀包括下腹悶脹感、性交疼痛、頻尿、解尿困難、經血過多等，嚴重甚至造成貧血、不孕，通常為多重原因，與女性荷爾蒙刺激及患者遺傳因素亦可能有關，好發於育齡女性，若有家族史其罹患機率更高。治療依症狀的嚴重程度、肌瘤生長方式、生育考量、患者對手術及子宮切除與否的接受度，建議的處理方式也有所不同。
陳建翰醫師表示，一般病人無不適症狀且肌瘤狀況穩定，通常定期回診追蹤即可，但若是肌瘤已引發明顯症狀，例如經血過多、經期過長、壓迫導致排尿及排便不順時，則建議接受手術治療；另外，若是子宮肌瘤生長位置靠近子宮腔及子宮角，亦可能影響受孕及胎兒生長，患者如有備孕計畫，最好先治療子宮肌瘤後再懷孕。
以往治療子宮肌瘤多以傳統剖腹手術為主，術後腹部傷口較大，需較長的恢復期，造成病人害怕而降低治療意願。近年，腹腔鏡及子宮鏡等微創手術發展訊速也提供病患另一種治療選擇，但無論傳統剖腹手術或內視鏡微創手術，都有可能會造成術後沾黏機率。
標靶音波刀則是一種無創手術，透過聚焦超音波熱能，消融體內子宮肌瘤，達到造成肌瘤組織壞死目的。治療過程不只在術前及術後會透過MRI磁振造影確認肌瘤狀況，術中也會搭配MRI磁振造影即時監測溫度，透過精準監測系統，提供更安全的治療過程。由於採用標靶音波刀不需開刀，因此不會產生傷口，亦大大減低術後沾黏機率，治療隔天即可出院正常活動；且因不會傷及子宮及其周邊組織，對於有懷孕計畫治療過程或不想接受侵入性手術治療的病患，提供另一種多元的選擇。
陳建翰醫師呼籲，子宮肌瘤難預防，平常應避免服用來路不明的藥物或補品，而針對子宮肌瘤患者，若無症狀且肌瘤穩定情況下，建議半年至一年回診一次，但如有症狀時，千萬不要輕忽，應儘早就醫檢查，並與醫師充分溝通，選擇最適合的治療方式。
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