高强度聚焦超声联合GnRH-a治疗子宫腺肌症的临床研究

发布时间：2018-05-16 16:57

  本文选题：子宫腺肌症 + 高强度聚焦超声　； 参考：《安徽医科大学》2017年硕士论文

【摘要】：目的探讨高强度聚焦超声(HIFU)联合促性腺激素释放激素激动剂(GnRH-a)治疗子宫腺肌症的临床疗效并分析患者年龄和病程对其疗效的影响。方法选取2014年12月至2016年1月在安徽省立医院确诊为子宫腺肌症的患者61例,均以痛经为主要症状且有生育要求,其中31例为实验组行HIFU联合GnRH-a治疗,30例为对照组行单纯HIFU治疗,评价两组患者术后6、12个月时的症状改善情况及复发率,对比研究术后1、6、12个月的痛经评分、月经量评分、子宫体积缩小率、糖类抗原125(CA125)值的变化以及不良反应、妊娠情况。将实验组以年龄38岁与≤38岁及病程4年与≤4年分别分为两组,比较两组的痛经及月经量评分下降程度、子宫体积缩小率。结果对照组术后6个月痛经及月经改善总有效率分别为79.31%(23/29)及70.37%(19/27)、术后12个月分别为73.08%(19/26)及70.83%(17/24),实验组术后6个月痛经及月经改善总有效率分别为96.77%(30/31)及92.86%(26/28)、术后12个月分别为89.29%(25/28)及92.31%(24/26),均明显高于对照组。对照组复发率19.23%(5/26),实验组复发率7.14%(2/28),实验组明显低于对照组,复发时间亦较其延迟。两组间术后6个月和12个月,实验组痛经评分、月经量评分、CA125水平均明显低于对照组,子宫体积缩小率明显高于对照组,差异有统计学意义(P0.05)。两组均无严重的不良反应发生。对照组妊娠2例,实验组妊娠4例,实验组高于对照组。实验组年龄38岁患者痛经评分下降及子宫体积缩小程度高于年龄≤38岁患者,病程4年患者痛经及月经量评分下降程度高于病程≤4年患者,差异有统计学意义(P0.05)。逡逡结论单纯HIFU治疗及HIFU联合GnRH-a治疗子宫腺肌症均安全有效,联合GnRH-a治疗较单纯HIFU治疗疗效更确切,可减少复发率,延迟复发,且更适用于年龄较大、病程较长的子宫腺肌症患者。
[Abstract]:Objective to investigate the clinical effect of high intensity focused ultrasound (HIFU) combined with gonadotropin releasing hormone agonist (GnRH-a) in the treatment of adenomyosis. Methods from December 2014 to January 2016, 61 cases of adenomyosis were diagnosed in Anhui Provincial Hospital. Dysmenorrhea was the main symptom and had fertility requirement. Among them, 31 cases were treated with HIFU combined with GnRH-a in the experimental group and 30 cases were treated with HIFU alone in the control group. The symptom improvement and recurrence rate of the two groups were evaluated at 6 and 12 months after operation. The scores of dysmenorrhea and menstrual volume at 1 and 12 months after operation were compared. Uterine volume reduction rate, carbohydrate antigen 125 CA125), adverse reactions, pregnancy. The experimental group was divided into two groups according to the age of 38 years or less than 38 years, the course of disease and the duration of 4 years and 鈮，

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