Effect of GnRH-a Combined with High Intensity Focused Ultrasound Ablation in the Treatment of Adenomyosis
Objective:To observe the effect of gonadotropin-releasing hormone agonist(GnRH-a)combined with high intensity focused ultrasound(HIFU)ablation in the treatment of adenomyosis.Method:A total of 76 patients with adenomyosis who admitted to Affiliated Hospital of Putian University from March 2020 to March 2021 were selected as the research objects,they were divided into the observation group and the control group by simple randomization method,with 38 cases in each group.The control group was given HIFU ablation,and the observation group was given GnRH-a combined with HIFU ablation.The menstrual status,uterine status,sex hormone levels,serum vascular endothelial growth factor(VEGF),carcinoembryonic antigen(CEA)and carbohydrate antigen 125(CA125)levels before and 6 months after operation and recurrence were compared between two groups.Result:At 6 months after operation,the pictorial blood loss assessment chart(PBAC)scores and visual analogue scale(VAS)scores of dysmenorrhea in two groups were lower than those before operation,and those in the observation group were lower than the control group,the differences were statistically significant(P<0.05);at 6 months after operation,the endometrial thickness and uterine volume of two groups were lower than those before operation,and those in the observation group were smaller than those in the control group,the differences were statistically significant(P<0.05);at 6 months after operation,the levels of estradiol(E2),luteinizing hormone(LH)and follicle-stimulating hormone(FSH)in the control group were not significantly different from those before operation(P>0.05),those in the observation group were lower than those before operation,and those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05);at 6 months after operation,the levels of serum VEGF,CEA and CA125 in two groups were lower than those before operation,and those in the observation group were lower than the control group,the differences were statistically significant(P<0.05);after 6 months of follow-up,there was no recurrence in the observation group and 2 cases(5.26%)in the control group,there was no significant difference in the recurrence rate between two groups(P>0.05).Conclusion:GnRH-a combined with HIFU ablation in the treatment of uterine adenomyosis is effective,which can improve symptoms such as dysmenorrhea and excessive menstruation,and reduce the levels of sex hormones,VEGF,CEA and CA125.
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