Effects Of GnRH-a And LNG-IUS On The Efficacy And Recurrence Rate Of HIFU Treated Adenomyosis

Objective: To evaluate the effect of highintensitv focused ultrasound(HIFU)combined with GnRH-a and levonorgestrel-relesing intrauterine system(LNG-IUS)in the treatment of adenomyosis and adenomyoma on improving clinical efficacy and reducing recurrence rate.Methods: The clinical data of 220 patients with adenomyosis and adenomyoma treated by HIFU,GnRH-a and LNG-IUS in the gynecological department of Xinjiang Uygur Autonomous Region People’s Hospital from January 2010 to December 2017 were retrospectively analyzed.The patients were divided into HIFU group,HIFU+GnRH-a group and HIFU+GnRH-a+LNG-IUS group according to the treatment plan.The changes of menstrual volume score,dysmenorrhea score,uterine volume and lesion volume before and after treatment were analyzed and compared.Results: The menstrual volume score,dysmenorrhea score,uterine volume and lesion volume at 3 months after treatment in the three groups were significantly lower than those before treatment(P < 0.05).There was no significant difference in recurrence rate between HIFU + GnRH-a group and HIFU + GnRH-a + LNG-IUS group one year after treatment(P > 0.05)but the recurrence rates of HIFU+GnRH-a group and HIFU+GnRH-a+LNG-IUS group were significantly different from those of HIFU group(P<0.05).There was no significant difference in recurrence rate between HIFU group and HIFU + GnRH-a group at 2,3 and more years after treatment(P > 0.05)but the recurrence rates of HIFU+GnRH-a+LNG-IUS group were significantly different from those of HIFU group and HIFU+GnRH-a group(P<0.05).Conclusion: HIFU combined with GnRH-a and LNG-IUS can improve the symptoms of patients,reduce the volume of uterus and lesions,improve the clinical efficacy and reduce the recurrence rate,which is worthy of clinical reference and promotion.