摘要
目的:探究高强度聚焦超声(HIFU)联合皮下醋酸亮丙瑞林缓释微球注射治疗子宫腺肌症(AM)患者疗效.方法:按随机数字表法将220例AM患者分对照组(n=110)、观察组(n=110).对照组患者行HIFU消融治疗,观察组联合皮下醋酸亮丙瑞林缓释微球注射治疗,于月经第一天进行.对比两组患者子宫腺肌病灶体积、痛经程度、月经量、血清性激素水平[黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)]及头晕恶心、腹痛及乳房痛等不良反应发生情况.结果:治疗3个月后、治疗6个月后两组AM病灶体积、VAS评分、PBAC评分均下降(P＜0.05),但观察组治疗3个月后、治疗6个月后的AM病灶体积较对照组小,视觉模拟尺(VAS)评分、月经失血图(PBAC)评分低于对照组(P＜0.05);治疗后两组患者血清中LH、FSH、E2水平均降低,且观察组低于对照组(P＜0.05);治疗后观察组并发症发生率为5.45％,低于对照组9.09％(P=0.299).结论:HIFU联合药物治疗AM患者疗效确切,可显著降低患者VAS及PBAC评分,改善血清激素水平,降低并发症发生情况.
Abstract
Objective:To explore the effect of high-intensity focused ultrasound(HIFU)combined with subcutaneous injection of leuprorelin acetate sustained-release microspheres in the treatment of patients with adenomyosis(AM).Methods:According to the ran-dom number table method,220 patients with AM admitted to Deyang People's Hospital from June 2021 to June 2023 were divided into the control group and the observation group,with 110 cases in each group.The control group was treated with HIFU ablation,while the observation group was treated with subcutaneous injection of leuprorelin acetate sustained-release microspheres on the first day of men-struation on the basis of the treatment of control group.Lesion volume,degree of dysmenorrhea,menstrual volume,serum sex hormones[luteinizing hormone(LH),follicle-stimulating hormone(FSH)and estradiol(E2)],and the incidence rates of adverse reactions such as dizziness and nausea,abdominal pain and breast pain were compared between the two groups.Results:After 3 and 6 months of treat-ment,the lesion volume,VAS scores and pictorial blood assessment chart(PBAC)scores in both groups were decreased(P＜0.05),and lesion volume of the observation group was smaller than that of the control group,the observation group had lower VAS scores and PBAC scores than the control group(P＜0.05).After treatment,serum LH,FSH and E2 levels in both groups decreased,and the levels in observation group were lower than those in the control group(P＜0.05).The incidence of complications in the observation group was 5.45％,lower than 9.09％in the control group(P=0.299).Conclusion:HIFU combined with combined with leuprorelin acetate sus-tained-release microspheres injection is effective in the treatment of patients with AM,which can significantly reduce VAS score and PBAC score,improve serum hormone levels,and reduce the incidence of complications.
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