高强度聚焦超声消融术单用及联合GnRH-a治疗不同等级血供子宫肌瘤的效果对比  

Comparison of the efficacy of high-intensity focused ultrasound ablation alone and combined with GNRH-A in the treatment of uterine fibroids with different grades of blood supply

作　　者：阳丽君[1] 刘君[1] 黄瑾[1] 苏园园[1] YANG Lijun;LIU Jun;HUANG Jin;SU Yuanyuan(Department of Gynecology,Zhongshan People’s Hospital,Zhongshan 528403,Guangdong,China)

机构地区：[1]中山市人民医院妇科,广东中山528403

出　　处：《当代医药论丛》2022年第16期87-91,共5页

基　　金：中山市社会公益科技研究项目,项目编号:2018SYF04。

摘　　要：目的:比较高强度聚焦超声(HIFU)消融术单用及联合促性腺激素释放激素激动剂(GnRH-a)治疗不同等级血供子宫肌瘤的效果。方法:选取中山市人民医院2018年7月至2020年3月期间收治的子宫肌瘤患者120例作为试验对象。按照随机数表法将其分为单独HIFU组(n=60)和GnRH-a联合组(n=60)。单用HIFU消融术对单独HIFU组患者进行治疗,用HIFU消融术联合GnRH-a对GnRH-a联合组患者进行治疗。比较两组患者的各项临床指标。结果:GnRH-a注射3针后,GnRH-a联合组患者瘤体内部的血供等级较治疗前明显下降。GnRH-a联合组患者术中的能效因子和不良事件的发生率均低于单独HIFU组患者,P<0.05。术后3个月、6个月及12个月,GnRH-a联合组患者的症状评分均低于单独HIFU组患者,其子宫肌瘤症状和健康相关生活质量问卷(UFS-QOL)评分均高于单独HIFU组患者,P<0.05。术后6个月及12个月,GnRH-a联合组患者的子宫体积缩小率和病灶体积缩小率均高于单独HIFU组患者,P<0.05。结论:用HIFU消融术联合GnRH-a治疗不同等级血供子宫肌瘤的效果显著,能有效减少肌瘤内部的血供及术中所需的能量,促使子宫和病灶的体积缩小,降低患者术中不良事件的发生率,减轻其临床症状,提高其生活质量。Objective:To compare the efficacy of high intensity focused ultrasound(HIFU)ablation alone and combined with gonadotropin-releasing hormone agonist(GNRH-A)in the treatment of uterine fibroids with different grades of blood supply.Methods:A total of 120 patients with uterine fibroids admitted to Zhongshan People’s Hospital from July 2018 to March 2020 were selected as experimental subjects.They were divided into HIFU alone group(n=60)and GNRH-A combined group(n=60)according to random number table method.HIFU ablation alone was used to treat HIFU patients alone,and HIFU ablation combined with GNRH-A was used to treat GNRH-A patients combined.The clinical indicators of the two groups were compared.Results:After 3 injections of GNRH-A,the blood supply level of patients in the combined gnRH-A group was significantly lower than that before treatment.The incidence of intraoperative energy efficiency factors and adverse events in gnRH-A combined group was lower than that in HIFU alone group,P<0.05.At 3,6 and 12 months after surgery,symptom scores of patients in gnRH-A combined group were lower than those in HIFU alone group,and uterine fibroids symptoms and health related quality of life questionnaire(UFS-QOL)scores were higher than those in HIFU alone group,P<0.05.At 6 months and 12 months after surgery,the uterine volume reduction rate and lesion volume reduction rate in gnRH-A combined group were higher than those in HIFU alone group,P<0.05.Conclusion:HIFU ablation combined with GNRH-A has a significant effect on the treatment of different grades of blood supplied uterine fibroids,which can effectively reduce the internal blood supply and intraoperative energy required for fibroids,promote the reduction of uterine and lesion volume,reduce the incidence of intraoperative adverse events,alleviate the clinical symptoms and improve the quality of life of patients.

关 键 词：高强度聚焦超声消融术 促性腺激素释放激素激动剂 血供 子宫肌瘤 

分 类 号：R711.74[医药卫生—妇产科学]