A Comparison of Clinical Efficacy of High Intensity Focused Ultrasound Ablation(HIFU)for Diffuse and Localized Adenomyosis
Objective To compare the clinical efficacy of high intensity focused ultrasound ablation (HIFU)in the treatment of diffuse and localized adenomyosis.Methods A total of 60 patients with adenomyopathy who received high intensity focused ultrasound (HIFU)treatment in the Haifu Treatment Room of Gynecology Department of our hospital from October,2017 to February,2021 were selected for the study.These patients were divided into two groups according to the properties of adenomyosis suggested by NMR,including:30 patients with diffuse type and 30 patients with limited type.Symptom severity score (SSS),visual analogue scale of pain (VAS),PBAC score of menstrual volume and health-related quality of life score (HRQL)of the two groups were recorded and compared before treatment,6 months and 12 months after treatment.The ablation effect was evaluated after 12 months of treatment,and sex hormone levels (FSH,LH,E2),anti-mullerian hormone (AMH)levels and sinus follicle (AFC)of the two groups were measured before and after 12 months of treatment.The clinical efficacy of the two groups was then calculated.Results There were no significant differences in SSS score,VAS score,PBAC score and HRQL score between the two groups before treatment (P>0.05).At 6 and 12 months after treatment,SSS score,VAS score and PBAC score were significantly decreased (P<0.05),while HRQL score was significantly increased (P>0.05).There was no significant difference between the two groups (P>0.05). The lesion volume and NPV of the diffuse group were greater than the limited group,and NPVR value was lower than the limited group,with a statistical significance (P<0.05).The differences of average power,treatment duration and irradiation duration in diffuse group were significantly higher than those in limited group (P<0.05).There was no significant difference in levels of FSH,LH,E2,AMH and AFC between the two groups before treatment (P<0.05).After treatment,FSH,LH and E2 were significantly decreased,while AMH was significantly increased (P<0.05).There was no significant difference in AFC between the two groups (P>0.05).The total effective rate of the diffuse group was 83.33％,while that of the limited group was 86.67％.There was no statistical difference in the total effective rate between the two groups (P<0.05).Conclusion High intensity focused ultrasound ablation(HIFU)has the same clinical efficacy in the treatment of diffuse and localized adenomyosis.
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