摘要
目的:将高强度聚焦超声(HIFU)消融与促性腺激素释放激素激动剂(GnRHa)联合用于子宫腺肌病患者的治疗,并结合临床实际探讨其应用价值。方法:将石家庄市第一医院妇产科2015年1月—2018年1月诊治的89例子宫腺肌病患者作为研究对象。将入组病例分为2组:HIFU联合GnRHa组(41例)和单纯HIFU组(48例),比较2组患者治疗后随访1年的疗效指标。结果:HIFU联合GnRHa组病灶体积缩小率和子宫体积缩小率均大于单纯HIFU组,差异有统计学意义(均P<0.05)。HIFU联合GnRHa组血红蛋白水平高于单纯HIFU组,差异有统计学意义(P=0.044)。HIFU联合GnRHa组痛经VRS评分亦优于单纯HIFU组,差异有统计学意义(P=0.018)。2组患者血清CA125水平和不良反应发生率比较,差异无统计学意义(均P>0.05)。结论:与仅采用HIFU消融比较,HIFU联合GnRHa治疗子宫腺肌病能更有效地缩小病灶体积和子宫体积,同时改善血红蛋白水平和痛经症状。
Objective:High-intensity focused ultrasound(HIFU) ablation combined with gonadotropin releasing hormone agonists (GnRHa) was used in the treatment of adenomyosis, and its clinical application value was discussed. Methods:Patients of adenomyosis diagnosed and treated in the Department of Obstetrics and Gynecology of the First Hospital of Shijiazhuang from January 2015 to January 2018 was taken as the research objects. The cases were divided into two groups: the combined GnRHa group (n=41) was treated with HIFU ablation combined with GnRHa, and the simple HIFU group (n=48) was treated with HIFU ablation alone. The curative effect indexes of the two groups were compared after one year′s follow-up. Results:The lesion volume and uterine volume reduction rates in the combined GnRHa group were higher than those in the simple HIFU group (P<0.05), and the hemoglobin level was higher ( P=0.044). The VRS score of dysmenorrhea in the combined GnRHa group was also better than that in the simple HIFU group ( P=0.018). There was no significant difference in serum CA125 level and incidence of adverse reactions between the two groups (P>0.05). Conclusions:Compared with HIFU ablation alone, the combination of HIFU and GnRHa has better lesion volume reduction rate and uterine volume reduction rate, and hemoglobin level and dysmenorrhea symptoms improve better.
作者
徐锋
镡丽霞
李盼
郭清
XU Feng;TAN Li-xia;LI Pan;GUO Qing(Department of Obstetrics and Gynecology,The First Hospital of Shijiazhuang,Shijiazhuang 050011,China)
出处
《国际妇产科学杂志》
CAS
2019年第6期618-620,640,共4页
Journal of International Obstetrics and Gynecology
基金
河北省重点研发计划项目(182777121D)
关键词
子宫腺肌病
高强聚焦超声消融
痛经
促性腺激素释放激素激动剂
Adenomyosis
High-intensity focused ultrasound ablation
Dysmenorrhea
Gonadotropin releasing hormone agonists
