Clinical study of high intensity focused ultrasound and uterine artery embolization in treating adenomyosis patients with different types
Objective To investigate the clinical efficacy of high intensity focused ultrasound(HIFU)and uterine artery embolization(UAE)in the treatment of adenomyosis(AM)patients with different types and the effects on uterine volume,sex hormone levels,anti-Müllerian hormone(AMH)levels and pregnancy rate.Methods A total of 120 AM patients admitted to Cangzhou People's Hospital from October 2017 to February 2021 were selected as the study subjects.According to the random number table method,the patients were divided into HIFU group and AE group with 60 cases in each group.HIFU group was treated with HIFU,UAE group was treated with UAE.The clinical efficacy,levels of sex hormones and AMH before and after treatment,pregnancy rate 1 year after treatment in two groups,ablation parameters and clinical symptoms of AM patients with different types in HIFU group,and clinical symptoms of AM patients with different types in UAE group were compared.Results The total clinical effective rate of HIFU group was higher than that of UAE group(P＜0.05).In HIFU group,the volume of lesion,volume of non-perfused area,and average power in diffuse type were all larger than localized type,treatment time and irradiation time were both longer than localized type(P＜0.05),and the ablation rate was lower than that in localized type(P＜0.05).In two group,the reduction of uterine volume in AM patients with diffuse type was higher than that in localized type,and the reduction degree of visual analogue scale(VAS)score was lower than that in localized type(P＜0.05).After treatment,serum levels of follicle stimulating hormone(FSH),estradiol(E2)and luteinizing hormone(LH)in two groups were all decreased,and those in HIFU group were lower than those in UAE group(P＜0.05).After treatment,AMH level in HIFU group was higher than that in UAE group(P＜0.05).One year after treatment,there was no significant difference in pregnancy rate between the two groups(P＞0.05).Conclusions HIFU has good clinical effect in the treatment of AM,which can improve serum sex hormone levels and improve ovarian function.The clinical treatment difficulty of patients with diffuse type is higher than that of patients with localized type,and the pregnancy rate of 1 year after treatment is similar between the two groups.
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