GnRH-a联合高强度聚焦超声消融手术治疗子宫腺肌症的效果  

Effect of GnRH-a Combined with High Intensity Focused Ultrasound Ablation in the Treatment of Adenomyosis

作　　者：严敏敏 陈婷 YAN Minmin;CHEN Ting(Affiliated Hospital of Putian University,Putian 351100,China;不详)

机构地区：[1]莆田学院附属医院,福建莆田351100

出　　处：《中外医学研究》2024年第34期48-52,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:观察促性腺激素释放激素激动剂(gonadotropin-releasing hormone agonist,GnRH-a)联合高强度聚焦超声(high intensity focused ultrasound,HIFU)消融手术治疗子宫腺肌症的效果。方法:选择2020年3月—2021年3月莆田学院附属医院收治的76例子宫腺肌症患者作为研究对象,采用简单随机化法分为观察组、对照组,各38例。对照组行HIFU消融术,观察组在HIFU消融术基础上联合GnRH-a治疗。比较两组术前、术后6个月月经情况、子宫情况、性激素水平及血清血管内皮生长因子(vascular endothelial growth factor,VEGF)、癌胚抗原(carcinoembryonic antigen,CEA)和糖类抗原125(carbohydrate antigen 125,CA125)水平及复发情况。结果:术后6个月,两组经血量评估量表(pictorial blood loss assessment chart,PBAC)评分、痛经视觉模拟评分法(visual analogue scale,VAS)评分较术前降低,且观察组低于对照组,差异有统计学意义(P<0.05);术后6个月,两组子宫内膜厚度、子宫体积较术前减小,且观察组小于对照组,差异有统计学意义(P<0.05);术后6个月,对照组雌二醇(estradiol,E_(2))、黄体生成素(luteinizing hormone,LH)、卵泡刺激素(follicle-stimulating hormone,FSH)水平较术前差异无统计学意义(P>0.05),观察组较术前降低,且观察组低于对照组,差异有统计学意义(P<0.05);术后6个月,两组血清VEGF、CEA和CA125水平较术前下降,且观察组低于对照组,差异有统计学意义(P<0.05);术后随访6个月,观察组无复发,对照组复发2例(5.26%),两组复发率比较差异无统计学意义(P>0.05)。结论:GnRH-a联合HIFU消融术治疗子宫腺肌症效果确切,可改善痛经、经量过多等症状,下调性激素及VEGF、CEA、CA125水平。Objective:To observe the effect of gonadotropin-releasing hormone agonist(GnRH-a)combined with high intensity focused ultrasound(HIFU)ablation in the treatment of adenomyosis.Method:A total of 76 patients with adenomyosis who admitted to Affiliated Hospital of Putian University from March 2020 to March 2021 were selected as the research objects,they were divided into the observation group and the control group by simple randomization method,with 38 cases in each group.The control group was given HIFU ablation,and the observation group was given GnRH-a combined with HIFU ablation.The menstrual status,uterine status,sex hormone levels,serum vascular endothelial growth factor(VEGF),carcinoembryonic antigen(CEA)and carbohydrate antigen 125(CA125)levels before and 6 months after operation and recurrence were compared between two groups.Result:At 6 months after operation,the pictorial blood loss assessment chart(PBAC)scores and visual analogue scale(VAS)scores of dysmenorrhea in two groups were lower than those before operation,and those in the observation group were lower than the control group,the differences were statistically significant(P<0.05);at 6 months after operation,the endometrial thickness and uterine volume of two groups were lower than those before operation,and those in the observation group were smaller than those in the control group,the differences were statistically significant(P<0.05);at 6 months after operation,the levels of estradiol(E_(2)),luteinizing hormone(LH)and follicle-stimulating hormone(FSH)in the control group were not significantly different from those before operation(P>0.05),those in the observation group were lower than those before operation,and those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05);at 6 months after operation,the levels of serum VEGF,CEA and CA125 in two groups were lower than those before operation,and those in the observation group were lower than the control group,the differences were sta

关 键 词：子宫腺肌症 促性腺激素释放激素激动剂 高强度聚焦超声 血管内皮生长因子 癌胚抗原 糖类抗原125 

分 类 号：R713.4[医药卫生—妇产科学]