微波消融联合药物治疗弥漫性子宫腺肌病的中远期疗效  

Midium and Long Term Efficacy of Microwave Ablation Combined with Medication in the Treatment of DiffuseAdenomyosis

作　　者：苗小花 何俊峰[2] 闫国珍[2] 刘扬[2] 熊睿 石包圣 王军[2] Miao Xiaohua;He Junfeng;Yan Guozhen;Liu Yang;Xiong Rui;Shi Baosheng;Wang Jun(Graduate School,Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou,InnerMongolia 014040,China;Department of Ultrasound Medicine,The First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou,Inner Mongolia 014010,China)

机构地区：[1]内蒙古科技大学包头医学院研究生院,内蒙古包头市014040 [2]内蒙古科技大学包头医学院第一附属医院超声医学科,内蒙古包头市014010

出　　处：《中国超声医学杂志》2024年第6期686-689,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨微波消融(MWA)联合促性腺激素释放激素激动剂(GnRH-a)、左炔诺孕酮宫内缓释系统(LNG-IUS)治疗弥漫性子宫腺肌病的中远期疗效。方法 收集子宫腺肌病患者90例,依据治疗方法分为3组:A组(MWA)、B组(MWA+GnRH-a)和C组(MWA+GnRH-a+LNG-IUS),术后随访3年,评估患者术前、术后子宫体积、痛经视觉模拟评分法(VAS)评分、月经量月经失量图(PBAC)评分、症状严重程度评分(SSS)和健康相关生活质量(HRQL)评分。结果 各指标在随访期与术前相比,差异均有统计学意义。各指标在随访时间与组别中均存在交互效应(P<0.001)。术后3年C组与A组相比,术后第2、第3年C组与B组相比子宫体积缩小程度更大,差异均有统计学意义(P<0.05),痛经缓解程度及月经量改善情况以及SSS-HRQL评分在3组间的比较均呈现出C组改善程度更佳,差异有统计学意义。结论 MWA联合GnRH-a、LNG-IUS治疗弥漫性子宫腺肌病的中远期疗效良好。Objective To explore the midium and long term efficacy of microwave ablation(MWA)combined with gona-dotropin releasing hormone agonist(GnRH-a)and levonorgestrel releasing intrauterine system(LNG-IUS)in the treatment of diffuse adenomyosis.Methods A total of 9o patients with adenomyosis were collected and divided into three groups based on treatment methods:group A(MWA),group B(MWA+GnRH-a),and group C(MWA+GnRH-a+LNG-IUS).Patients were followed up for 3 years postoperatively to evaluate their preoperative and postoperative uterine volume,the visual ana-logue scale(VAS)of dysmenorrhea,the pictorial blood loss assessment chart(PBAC)score of menstrual volume,and the symptom severity score(SSS)and health-related quality of life(HRQL)scores.Results All indicators were statistically significant during the follow-up period compared to that before surgery.There was an interactive effect(P<0.001)between the follow-up time and the grouping of each indicator.Compared with group A at 3 years after surgery,and compared with group B at 2 and 3 years after surgery,group C showed a greater degree of uterine volume reduction,with statistical signifi-cance(P<0.05).The degree of dysmenorrhea relief and improvement in menstrual volume,as well as the comparison of SSS HRQL scores among the three groups,all showed a better improvement degree in group C,and the difference was statis-tically significant.Conclusions Microwave ablation combined with GnRH-a and LNG-IUS has a good midium and long term therapeutic effect on diffuse adenomyosis.

关 键 词：子宫腺肌病 微波消融 促性腺激素释放激素激动剂 左炔诺孕酮宫内缓释系统 中远期疗效 

分 类 号：R711.71[医药卫生—妇产科学]