Abstract：Objective To compare the clinical effect of only high intensity focused ultrasound ablation surgery (FUAS), FUAS combined with levonorgestrel releasing intrauterine system (LNG-IUS) and FUAS combined with dienogest(DNG) in the treatment of adenomyosis(AM). Methods A total of 150 patients with AM, who were treated in our hospital, were divided into three groups according to the difference of drug use: group A (FUAS treatment only), group B (FUAS combined with LNG-IUS) and group C (FUAS combined with DNG), with 50 cases in each group. The uterine volume, lesion volume, dysmenorrhea score, hemoglobin (HB) and level of serum CA125 were recorded separately at four points, namely before ablation (T1), 3 th(T2) ,6 th(T3) and 12 th(T4) month after ablation. Results Compared with the point of T1, at the points of T2-T4, the uterine volume, lesion volume, serum CA125 and VAS scores decreased (P<0.01) and HB became significantly higher (P<0.01) in the three groups. At the point of T4, the above mentioned four data were lower (P<0.05 ) in group B and group C than those in group A, and the uterine volume, dysmenorrhea score and serum CA125 in group C were significantly lowerthan those in group B (P<0.01). Conclusions The three treatment methods of FUAS are effective to prevent the recurrence and improve the clinical symptoms effectively, especially the treatment of FUAS combined with DNG.
董欣, 张亚琴, 庞晓卿, 秦丽欣, 杨茉, 任鹏, 李晓雪. 高强度聚焦超声消融术联合不同药物治疗子宫腺肌病的临床疗效[J]. 武警医学, 2022, 33(10): 843-847.
DONG Xin, ZHANG Yaqin, PANG Xiaoqing, QIN Lixin, YANG Mo, REN Peng, LI Xiaoxue. Clinical effect of high intensity focused ultrasound ablation surgery combined with different drugs in treatment of adenomyosis. Med. J. Chin. Peop. Armed Poli. Forc., 2022, 33(10): 843-847.
Gordts S, Grimbizis G, Campo R. Symptoms and classification of uterine adenomyosis, including the place of hysteroscopy in diagnosis[J]. Fertil Steril,2018,109(3):380-388.
[3]
Lee J S, Hong G Y, Lee K H,et al. Safety and efficacy of ultrasound guided high-intensity focused ultrasound treatment for uterine fibroids and adenomyosis [J]. Ultrasound Med Biol,2019,45(12):3214-3221.
[4]
Dessouky R, Gamil S A, Nada M G,et al. Management of uterine adenomyosis: current trends and uterine artery embolization as a potential alternative to hysterectomy [J]. Insights Imaging,2019,10(1): 48-56.
Guo S W, Groothuis P G. Is it time for a paradigm shift in drug research and development in endometriosis /adenomyosis[J]. Human Reproduction Update,2018,24(5) :577-598.
[10]
Guo Q, Xu F, Ding Z,et al. High intensity focused ultrasound treatment of adenomyosis:a comparative study[J]. Int J Hyper thermia,2018,11:1-5.
Huang B S, Seow K M, Tsui K H,et al. Fertility outcome of infertile women with adenomyosis treated with the combination of a conservative microsurgical technique and GnRH agonist: long-term follow-up in a series of nine patients[J]. Taiwan J Obstet Gynecol,2012,51(2):212-216.
[13]
Sheth S S, Ray S S. Severe adenomyosis and CA125[J]. J Obstet Gynaecol,2014,34(1):79-81.
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