GnRH-a预处理联合HIFU消融治疗弥漫型子宫腺肌病的临床疗效  

Clinical efficacy of gonadotropin-releasing hormone agonist pre-treatment combined with high-intensity focused ultrasound ablation for the treatment of diffuse adenomyosis

作　　者：宋学薇 赵明阳 贾凡 卢杰红 史丽坤 杨秀梅 SONG Xuewei;ZHAO Mingyang;JIA Fan;LU Jiehong;SHI Likun;YANG Xiumei(Department of Gynaecology,Cangzhou People′s Hospital,Cangzhou 061002,Hebei,China)

机构地区：[1]河北省沧州市人民医院妇科,河北沧州061002

出　　处：《中国性科学》2024年第9期75-79,共5页Chinese Journal of Human Sexuality

基　　金：河北省医学科学研究课题计划项目(20232088)。

摘　　要：目的探讨促性腺激素释放激素激动剂(GnRH-a)预处理联合高强度聚焦超声(HIFU)消融治疗弥漫型子宫腺肌病的临床疗效。方法选取2020年3月至2022年4月河北省沧州市人民医院收治的120例弥漫型子宫腺肌病患者作为研究对象,按照随机数字表法分为对照组与研究组,每组60例。对照组采用HIFU消融治疗,研究组采用HIFU消融治疗前先进行GnRH-a预处理。比较两组HIFU治疗时间、累积功率、存在靶区灰度变化情况,治疗前后痛经程度、月经量、子宫体积,治疗后痛经、月经量改善情况及随访期内再次干预情况。结果研究组治疗时间短于对照组,累积功率低于对照组(P<0.05),两组存在靶区灰度变化情况比较,差异无统计学意义(P>0.05)。治疗后3、6个月,两组视觉模拟评分法(VAS)、月经量评分、子宫体积均降低,且研究组均低于对照组(P<0.05)。治疗后3、6个月,研究组痛经、月经量改善有效率均高于对照组(P<0.05)。术后1年随访期内,两组行子宫切除术、病灶切除术、再次进行HIFU及妊娠情况比较,差异无统计学意义(P>0.05)。结论采用HIFU消融治疗弥漫型子宫腺肌病患者前,先进行GnRH-a预处理,可缩短HIFU治疗时间,提高治疗效果,改善痛经和月经量情况。Objective To discuss the clinical efficacy of gonadotropin-releasing hormone agonist(GnRH-a)pre-treatment combined with high-intensity focused ultrasound(HIFU)ablation for the treatment of diffuse adenomyosis.Methods A total of 120 patients with diffuse adenomyosis treated at the Cangzhou People′s Hospital,Hebei Province from March 2020 to April 2022 were selected as study objects and randomly divided into a control group and a study group,with 60 patients in each group.The control group received HIFU ablation treatment,while the study group underwent GnRH-a pre-treatment before HIFU ablation.The HIFU treatment duration,cumulative power,changes condition in target area grayscale,dysmenorrhea degree,menstrual volume,uterine volume before and after treatment,and improvements in dysmenorrhea and menstrual volume,as well as reinterventions during the follow-up period were compared between the two groups.Results The treatment duration in the study group was shorter than in the control group,and the cumulative power was lower(P<0.05).No significant differences were observed in changes in target area grayscale between the two groups(P>0.05).At 3 and 6 months post-treatment,the visual analogue scale(VAS)scores,menstrual volume scores,and uterine volumes decreased in both groups,with the study group showing lower values than the control group(P<0.05).At 3 and 6 months post-treatment,the effectiveness of improvement in dysmenorrhea and menstrual volume were both higher in the study group than in the control group(P<0.05).During the one-year postoperative follow-up period,there were no significant differences between the groups in terms of hysterectomy,lesion excision,repeat HIFU treatment,and pregnancy condition(P>0.05).Conclusions Pre-treating patients with diffuse adenomyosis with GnRH-a before HIFU ablation can shorten the treatment duration and improve the treatment effects,as well as alleviate dysmenorrhea and menstrual volume condition.

关 键 词：促性腺激素释放激素激动剂 高强度聚焦超声 弥漫型子宫腺肌病 痛经 月经量 

分 类 号：R711[医药卫生—妇产科学]