高强度聚焦超声消融联合孕三烯酮治疗子宫腺肌病的疗效评价

目的 观察高强度聚焦超声(HIFU)消融联合孕三烯酮治疗子宫腺肌病的疗效.方法 将60例子宫腺肌病患者分为HIFU组和HIFU联合药物组,每组30例,比较两组患者治疗前后痛经、经量、子宫及病灶体积变化等情况.结果 两组患者治疗后6、12个月经量、痛经评分比较,差异均有统计学意义(P＜0.05);联合药物组患者治疗后病灶体积、子宫体积低于HIFU组,但差异无统计学意义(P＞0.05).治疗后6个月联合药物组血红蛋白水平与HIFU组比较,差异有统计学意义(P＜0.05).随访期联合药物组有5例妊娠,无复发病例,8例患者肝功能转氨酶轻度异常,停药后1个月复查正常;HIFU组1例妊娠,4例复发.结论 HIFU消融联合孕三烯酮治疗能有效缓解子宫腺肌病患者的临床症状.

Efficacy of high-intensity focused ultrasound ablation combined with gestrinone for treating adenomyosis

Objective To investigate the efficacy of high-intensity focused ultrasound(HIFU) ablation combined with gestrinone for treating adenomyosis.Methods Sixty patients with adenomyosis were divided into the HIFU group(n=30) and HIFU combined medication group(n =30).The change of dysmenorrheal,menstrual volume,volumes of uterus and lesion in the two group were compared between before and after treatment.Results The menstrual volume and dysmenorrhea scores at 6,12 months after treatment showed a statistical difference between the two groups(P＜0.05);the volumes of and adenomyotic lesion and uterus after treatment in the combined medication group were lower than those in the HIFU group,but the difference was not statistically significant(P＞0.05).The hemoglobin level after 6-month treatment had statistical difference between the combined medication group and HIFU group(P＜0.05).During the follow-up period,there were 5 cases of pregnancy without recurrence cases in the combine medication group,8 cases had slight abnormality in the liver function transaminase and recovered to normal in re-examination at 1 month after drug withdrawal;1 case had pregnancy and 4 cases had recurrence in the HIFU group.Conclusion HIFU ablation combined with gestrinone can effectively alleviate the clinical symptoms in the patients with adenomyosis.