Objective Comparison of the efficacy and safety of dienogest after high-intensity focused ultrasound(HIFU)therapy in pa-tients with adenomyosis.Methods A total of 102 patients with adenomyosis who were treated in Qinzhou Maternal and Child Health Hospital from August 2021 to October 2022 were prospectively selected as the study subjects.The patients were divided into the control group and the observation group by simple random method,51 cases in each group.Both groups were given HIFU treatment,and the observation group was given postopera-tive dienogest treatment,oral,2 mg/times,1 times/d,continuous treatment of 3 menstrual cycles.The lesion volumes of the two groups before op-eration,3 months after operation and 1 year after operation were compared,and the uterine volume reduction rates of the two groups 3 months after operation and 1 year after operation were calculated.The changes of carbohydrate antigen 125(CA125),hemoglobin,prostaglandin 2α(PG2α),sex hormones(estradiol,luteinizing hormone),visual analogue scale(VAS)score and menstrual volume score were compared between the two groups before operation,3 months after operation and 1 year after operation,and the occurrence of adverse reactions in the two groups was recor-ded.Results At 3 months and 1 year after operation,the lesion volume of the two groups was lower than that before operation,and the differ-ences were statistically significant(P＜0.05).The lesion volumes of the observation group at 3 months and 1 year after operation were(18.32±2.98)and(14.34±2.34)cm3,respectively,which were lower than those of the control group[(19.89±3.12)and(16.17±2.82)cm3],and the uterine volume reduction rates were(27.84±6.01)％and(39.04±5.11)％,respectively,which were higher than those of the control group[(23.26±5.78)％and(34.56±6.59)％],the differences were statistically significant(P＜0.05).At 3 months and 1 year after operation,the levels of CA125 and PGF2α in the two groups were lower than those before operation,and the hemoglobin level was higher than that before operation,the differences were statistically significant(P＜0.05).The levels of CA125 and PGF2α in the observation group were(48.96±18.97)U/mL and(391.65±51.45)μg/mL at 3 months after operation,and(36.25±8.47)U/mL and(231.02±34.71)μg/mL at 1 year after operation.Which were lower than those of the control group[(61.01±22.36)U/mL,(465.51±57.43)μg/mL and(41.12±10.05)U/mL,(284.53±43.65)μg/mL],the differences were statistically significant(P＜0.05).There was no statistically significant difference in hemoglobin level between the observation group and the control group(P＞0.05).At 3 months and 1 year after operation,the lev-els of estradiol and luteinizing hormone in the two groups were lower than those before operation,the differences were statistically significant(P＜0.05);there were no statistically significant differences in the levels of estradiol and luteinizing hormone between the observation group and the control group at 3 months and 1 year after operation(P＞0.05).The cumulative adverse reaction rate of the observation group was 10.00％,compared with 12.00％of the control group,the difference was no statistically significant(P＞0.05).Conclusion Dinogestrel used in patients with adenomyosis of the uterus after high-intensity focused ultrasound ablation therapy can reduce the patient's expression of CA125,PGF2α,shrink the lesions,improve the amount of menstruation with good safety.
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