高强度聚焦超声（HIFU）联合药物治疗子宫腺肌病的效果观察

发布时间：2018-01-06 18:53

本文关键词：高强度聚焦超声（HIFU）联合药物治疗子宫腺肌病的效果观察　出处：《河北医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨高强度聚焦超声(HIFU)联合不同药物治疗子宫腺肌病的疗效及安全性。方法:收集子宫腺肌病患者96例,随机分为为HIFU组、HIFU+LNG-IUS组、HIFU+米非司酮组、HIFU+GnRH-a组4组,每组各24例。HIFU组:不用任何药物,单纯行HIFU治疗。HIFU+LNG-IUS组:在HIFU术后约1-2周,炎症急性反应期结束后,于月经期第2-7天内,将LNG-IUS置入宫腔内。HIFU+米非司酮组:在HIFU术前1个月或术后开始用米非司酮10mg口服,每日1次。HIFU+GnRH-a组:术前1个月或术后开始用药,于月经来潮1~3d接受Gn RH-a针3.75 mg、每4周1次。收集各种数据,比较各组在术前、术后3个月、6个月、12个月时的痛经评分、经量评分、子宫体积、血清CA125水平及子宫动脉血流Vmax、Vmin、RI的变化情况。结果:四组患者术后3个月、6个月、12个月时的痛经评分、经量评分、子宫体积、血清CA125水平及子宫动脉血流Vmax、Vmin、RI均较术前明显降低(P0.05),HIFU+LNG-IUS组、HIFU+米非司酮组、HIFU+GnRH-a组三组术后3个月、6个月、12个月时的痛经评分、经量评分、子宫体积、血清CA125水平及子宫动脉血流Vmax、Vmin、RI比较差异无统计学意义(P0.05),但均较单纯HIFU组明显降低,差异有统计学意义(P0.05)。四组的不良反应发生率比较差异无统计学意义(P0.05)。结论:HIFU联合LNG-IUS、米非司酮、GnRH-a均能不同程度的改善患者的症状,改善子宫的血流动力学,提高疗效,且不良反应并没有明显增加,值得临床借鉴推广。
[Abstract]:Objective: To investigate the effect of high intensity focused ultrasound (HIFU) clinical efficacy and safety of combination of different drugs in the treatment of adenomyosis. Methods: We collected 96 cases of patients with adenomyosis, were randomly divided into HIFU group, HIFU+LNG-IUS group, HIFU+ administration group, HIFU+GnRH-a group of 4 groups, 24 cases in each group:.HIFU group without any drug alone, HIFU treatment group.HIFU+LNG-IUS: about 1-2 weeks after HIFU, acute inflammatory reaction after the end of the period, the menstrual period in 2-7 days, the LNG-IUS was implanted into the uterine cavity of.HIFU+ mifepristone group in 10mg oral mifepristone HIFU 1 months before the operation or after the operation began, 1 times a day.HIFU+GnRH-a group: before 1 month or after the start of treatment, menstruation 1~3d accept Gn RH-a pin 3.75 mg, 1 times every 4 weeks. Collect all kinds of data, were compared in preoperative, postoperative 3 months, 6 months, 12 months after the dysmenorrhea score, score, uterine volume, the level of CA125 and the uterus arterial blood serum The blood flow of Vmax, Vmin, RI changes. Results: 3 months after operation in the four groups, 6 months, 12 months after the dysmenorrhea score, score, volume of uterus and uterine artery blood serum level of CA125 and Vmax, Vmin, RI were significantly decreased (P0.05), HIFU+LNG-IUS group HIFU+, mifepristone group, HIFU+GnRH-a group 3 months after operation in three groups, 6 months, 12 months after the dysmenorrhea score, score, volume of uterus and uterine artery blood serum level of CA125 and Vmax, Vmin, RI showed no significant difference (P0.05), but compared with the pure HIFU group was significantly reduced. The difference was statistically significant (P0.05). The adverse reactions of the four groups were no significant differences (P0.05). Conclusion: HIFU combined with LNG-IUS, GnRH-a mifepristone, significantly improve the symptoms of patients, improve the hemodynamics of uterus, improving the curative effect and adverse reaction, and no significant increase, it is worthy of clinical use Promote it.

【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R711.71

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