高强度聚焦超声消融联合GnRH-a治疗子宫腺肌病的临床效果及其预后复发情况分析

doi:10.3969/j.issn.1006-6233.2023.07.021

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Abstract Objective: To analyze the clinical effects of high-intensity focused ultrasound (HIFU) combined with gonadotropin-releasing hormone agonist (GnRH-a) in the treatment of adenomyosis and evaluate the prognosis and recurrence. Methods: The clinical data of 122 patients with adenomyosis treated in the hospital were retrospectively analyzed between June 2018 and December 2020.56 patients were treated with single GnRH-a (GnRH-a group),and 66 patients performed HIFU combined with GnRH-a (HIFU+GnRH-a group).The uterine volume,dysmenorrhea degree[Visual Analogue Scale (VAS)],menstrual volume,endometrial receptivity (the quantity and maturity of endometrial pinoplasts) and ovarian function[follicle-stimulating hormone (FSH),luteinizing hormone (LH),estradiol (E2)] were compared between the two groups before treatment and at 6 months after the treatment.The adverse reactions of treatment and recurrence-free survival rate at 12 months after the end of treatment were recorded in the two groups. Results: At 6 months after the treatment,the uterine volume,dysmenorrhea VAS score,and menstrual flow score in the two groups were significantly reduced compared with those before treatment (P<0.05),and the above indicators in HIFU+GnRH-a group were lower than those in GnRH-a group (P<0.05).The quantity and maturity of endometrial pinoplasts in both groups were enhanced compared to before treatment (P<0.05),and the two indicators were higher in HIFU+GnRH-a group than those in GnRH-a group (P<0.05).At 6 months after the treatment,there were no significant changes in serum FSH,LH and E2 levels in the two groups compared with those before treatment (P>0.05),and there were no significant differences between the two groups (P>0.05).The difference in incidence rate of adverse reactions was not statistically significant (12.12% vs 5.36%) (P>0.05).The recurrence-free survival rate at 12 months after the end of treatment in HIFU+GnRH-a group was higher than that in GnRH-a group (P<0.05). Conclusion: The combined treatment of HIFU and GnRH-a is more significant in relieving the clinical symptoms of adenomyosis,more beneficial to improving endometrial receptivity and more effective in reducing the recurrence rate,with good safety.

Key words： Adenomyosis High-intensity focused ultrasound Gonadotropin-releasing hormone agonist Recurrence

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2023.07.021 OR http://www.hbyxzzs.cn/EN/Y2023/V29/I7/1169

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