磁共振引导聚焦超声与促性腺激素释放激素激动剂联合左炔诺孕酮宫内缓释系统治疗复发性子宫肌瘤的临床效果  

Clinical effect of MR-guided high intensity focused ultrasound and gonadotropin releasing hormone agonist combined with levonorgestrel-releasing intrauterine system in the treatment of recurrent uterine fibroids

作　　者：郭静[1] 陈英超[1] 杨丹[1] 姜娟[1] Guo Jing;Chen Yingchao;Yang Dan;Jiang Juan(Department of Obstetrics and Gynaecology, the First Hospital of Harbin, Heilongjiang 150000, China)

机构地区：[1]黑龙江省哈尔滨市第一医院妇产科,150000

出　　处：《中国综合临床》2018年第4期352-355,共4页Clinical Medicine of China

摘　　要：目的探讨磁共振引导聚焦超声与促性腺激素释放激素激动剂联合左炔诺孕酮宫内缓释系统治疗复发性子宫肌瘤的临床效果。方法以我院2015年4月至2017年6月收治的80例复发性子宫肌瘤患者为研究对象，随机分为观察组与对照组各40例，接受磁共振引导高强度聚焦超声治疗为观察组，第1次注射促性腺激素释放激素激动剂后放置左炔诺孕酮宫内缓释系统设为对照组。比较两组患者治疗后3、6个月肌瘤体积、血红蛋白含量、月经量以及不良反应方面的情况。结果6个月后观察组患者的子宫肌瘤大小（80.23±4.35） cm^3明显低于对照组（135.46±9.25） cm^3，差异有统计学意义（t＝6.01，P〈0.05），治疗后3、6个月，观察组的月经量均明显低于对照组[（66.37 ±12.12）分与（98.42 ±14.12）分、（40.46±10.15）分与（68.26±11.38）分]，差异有统计学意义（t术后3个月＝4.52，P〈0.05；t术后6个月＝3.53，P〈0.05），治疗后6个月观察组血红蛋白值显著高于对照组[（142.12±4.24） g/L与（108.27±3.09 ） g/L]，差异有统计学意义（t＝5.02，P〈0.05），而术后6个月阴道出血、潮热、盗汗等不良反应均低于对照组[2.5%（1/40）与7.5%（3/40）]（χ^2＝3.99，P〈0.05）。结论磁共振引导高强度聚焦超声作为一种新型无创的治疗复发性子宫肌瘤的方法安全有效，不良反应小，值得临床应用。Objective To explore the clinical effects of magnetic resonance guided high intensity focused ultrasound（MRgHIFU） and gonadotropin releasing hormone agonist（GnRH-a） combined with levonorgestrel-releasing intrauterine system （LNG-IUS） in the treatment of recurrent uterine fibroids.Methods Eighty patients of recurrent uterine fibroids from April 2015 to June2017 in the First Hospital of Harbin were collected and randomly divided into the observation group and control group.MRgHIFU was used in the observation group were employed, and patients in the control group were treated with ING-IUS after first injecting GnRH-a.The tumor volume, hemoglobin level, menstrual quantity and adverse reactions were compared before and at 3 months, 6 months after treatment.Results After 6 months, the size of the uterine myoma in the observation group was （（80.23±4.35） cm^3）, significantly lower than that of the control group （（135.46±9.25） cm^3）, and the difference was statistically significant （t=6.01, P〈0.05）. At 3 and 6 months after treatment, the amount of menstruation in the observation group was significantly lower than that of the control group（ （66.37±12.12）points vs.（40.46±10.15） points; （98.42±14.12） points vs.（68.26±11.38） points）. The difference was statistically significant （t at 3 months after treatment=4.52, P〈0.05, t at 6 months after treatment=3.53, P〈0.05）. After 6 months of treatment, the hemoglobin value of the observation group was significantly higher than that of the control group （（142.12±4.24） g/L vs.（108.27±3.09） g/L）, the difference was statistically significant （t=5.02, P〈0.05）, while the adverse reactions such as vaginal bleeding, hot flashes and night sweats were lower than those of the control group （2.5% （1/40） vs.7.5% （3/40）） （χ^2=3.99, P〈0.05）.Conclusion Magnetic resonance guided high intensity focused ultrasound was considered as safe and effective in treating uterine fibroids, which is a new an

关 键 词：磁共振引导聚焦超声 促性腺激素释放激素激动剂 左炔诺孕酮宫内缓释系统 复发性子宫肌瘤 

分 类 号：R737.33[医药卫生—肿瘤]