高强度聚焦超声联合亮丙瑞林治疗子宫腺肌病30例分析  

Analysis of 30 cases of adenomyosis treated with high-intensity focused ultrasound combined with leuprolide

作　　者：任娟 桑学梅[1] 刘艳 吴霞[1] 闫井正 REN Juan;SANG Xuemei;LIU Yan;WU Xia;YAN Jingzheng(Department of Gynecology,General Hospital of Wanbei Coal and Electricity Group,Suzhou,Anhui 234000,China)

机构地区：[1]皖北煤电集团总医院妇科,安徽宿州234000

出　　处：《安徽医药》2020年第7期1381-1384,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的分析高强度聚焦超声(High Intensity Focused Ultrasound,HIFU)联合促性腺激素释放激素激动剂(GonadotropinReleasing Hormone Agonist,GnRH-α)对子宫腺肌病的治疗及预后影响分析。方法选取2017年6月至2019年4月在皖北煤电集团总医院行HIFU治疗的60例子宫腺肌病病人,采用随机数字表法分为研究组和对照组各30例,研究组行HIFU联合亮丙瑞林皮下注射治疗,对照组行HIFU联合米非司酮口服治疗。分别于治疗前、治疗后第3个月和第6个月测定视觉模拟评分(visual analogue scale,VAS)、月经量、血清CA125水平、血红蛋白含量及子宫体积值。结果两组病人的痛经评分、月经量、子宫体积、血清CA125水平均较治疗前下降,血红蛋白含量高于治疗前,差异有统计学意义(P<0.05)。研究组与对照组相比,月经量减少和血红蛋白上升差异无统计学意义(P>0.05),但VAS评分[(4.87±1.01)比(5.43±0.97)分,(3.63±1.03)比(4.20±0.93)分]、子宫体积缩小[(159.47±48.23)比(198.30±51.33)cm3,(118.83±34.29)比(142.63±38.21)cm3]和CA125水平下降[(53.03±14.88)比(62.03±16.14)U/mL,(34.47±10.74)比(43.03±10.57)U/mL]均优于对照组,差异有统计学意义(P<0.05)。在复发率方面,两组比较差异无统计学意义(P>0.05),在治疗费用方面,研究组高于对照组。结论 HIFU联合GnRH-a治疗子宫腺肌病的短期疗效优于HIFU联合米非司酮治疗,是一种临床值得推广的治疗方案。Objective To analyze the effects of high intensity focused ultrasound(HIFU)combined with gonadotropin-releasinghormone agonist(GnRH-α)on the treatment and prognosis of adenomyosis.MethodsA total of 60 patients with adenomyosiswere treated with HIFU at the General Hospital of Wanbei Coal and Electricity Group from June 2017 to April 2019 and were di-vided into a study group and a control group with 30 patients in each group by random number table method.The study group re-ceived HIFU combined with GnRH-α,and the control group was treated with HIFU combined with mifepristone.The visual ana-logue scale(VAS),menstrual volume,serum CA125 level,hemoglobin content and uterine volume values before treatment,at 3 months and 6 months after treatment of the study group and the control group were measured and compared.ResultsThe dysmen-orrhea score,menstrual volume,uterine volume,and serum CA125 levels of both groups after treatment were lower than those be-fore treatment,while hemoglobin content was increased,and the differences were statistically significant(P<0.05).Compared withthe control group,there was no significant difference in the reduction of menstrual flow and the increase of hemoglobin in the studygroup(P>0.05),but the VAS score[(4.87±1.01)vs.(5.43±0.97),(0.63±1.03)vs.(4.20±0.93)],uterine volume reduction[(159.47±48.23)vs.(198.30±51.33)cm3,(118.83±34.29)vs.(142.63±38.21)cm3],and CA125 level[(53.03±14.88)vs.(62.03±16.14)U/mL,(34.47±10.74)vs.(43.03±10.57)U/mL]were all higher than those of the control group,and the differenceswere statistically significant(P<0.05).In terms of recurrence rate,there was no significant difference between the two groups(P>0.05),while of treatment costs,the study group was higher than the control group.ConclusionThe short-term efficacy of HIFUcombined with GnRH-αin the treatment of adenomyosis is superior to HIFU combined with mifepristone.Therefore,it is a clinicallyworthwhile treatment plan.

关 键 词：子宫疾病 高强聚焦超声消融 亮丙瑞林 促性腺素释放激素(GnRH-a) 子宫腺肌病 米非司酮 

分 类 号：R711.71[医药卫生—妇产科学]