| Adenomyosis(AM),also known as the specific form of endometriosis in the uterus,is a common gynecological disease among women of childbearing age,and its pathologic features are ectopic endometrial glands in the endometrium(50%),secondary dysmenorrhea(30%)and uterine enlargement of the triple sign,and often feel the frequent urination and urgent uriInation,severe,and other symptoms of the uterus,the most common clinical features include abnormal uterine bleeding Affect the patient’s physical and mental health.Total hysterectomy is the only effective treatment for radical adenomyosis,but for those who have fertility requirements,it is not a "disaster",high intensity focused ultrasound(HIFU)as a Non-invasive treatment,more and more play a pivotal role in the treatment of AM,the study found that HIFU is an effective and low-risk treatment options,especially for the treatment of adenomyosis and uterine fibroids has been promoted,For the majority of female patients brought the Gospel.Clinical indications of tumor markers are often used for the screening,diagnosis and detection of specific diseases.Carcinoembryonic antigen 125(CA125)is commonly used to detect molecular markers of ovarian cancer,but the study found that CA125 expression levels and adenomyosis And closely related to the development of adenomyosis in patients with serum levels of CA125 higher levels,and other reports of adenomyosis in patients with ectopic endometrial secretion of CA125 function is the normal endometrial 2-4 times that serum CA125 Level and the degree of diffuse and the range of lesions of adenomyosis was positively correlated.However,there has been no study on the relationship between serum CA125 levels in HIFU patients with adenomyosis and the relationship between serum CA125 levels and improved clinical symptoms of adenomyosis,so the aim of this study is to Ultrasound focused ultrasound treatment of adenomyosisbefore and after serum CA125 level analysis and observation of CA125 levels and clinical symptoms of the relationship between the changes.Analysis was used of 132 cases about adenomyosis with treatment of high intensity focused ultrasound(High Intensity Focused Ultrasound,HIFU)in obstetrics and gynecology of the first hospital of Shijiazhuang in June 2015 to June 2016,12 cases was lost to follow up in the process,Follow-up of changes in clinical symptoms and changes in key indicators.The effect of HIFU ablation on adenomyosis was evaluated by comparing the correlation of dysmenorrhea score,menstrual score,hemoglobin content and serum CA125 level in preoperative and postoperative patients.Objective:1 To analyse the clinical efficacy of HIFU ablation in the treatment of adenomyosis.2 To compare the relationship between the level of serum CA125 and the improvement of clinical symptoms in patients with adenomyosis treated by HIFU,so as to explore the prognostic significance of HIFU in the treatment of adenomyosis.Method: Selected datas from adenomyosis to visit our hospital,and according to the patient’s indications and their own wishes to receive HIFU treatment.The patients were followed up at 1 month,3 months and 6 months after treatment.The follow-up included postoperative dysmenorrhea,changes in menstrual flow,improvement of gynecological ultrasound and anemia,and serum CA125 level.To analyze the correlation between serum CA125 level and clinical symptom change,Comparison of the indicators using the variance analysis or Kruskal-Wallis test.Result:1 The scores of dysmenorrhea in HIFU patients were decreased compared with those before operation.The index of 1,3,6 month were 3.5(3.75),3.0(3)and 2.5(2),respectively.The difference was statistically significant;2 The monthly menstrual score of HIFU patients was lower than that of preoperative and postoperative scores at 3 months and 6 months,the scoreswere 3.0(1)and 3.0(1.75),respectively,the difference was statistically significant;3 The uterine volume of patients was gradually reduced after HIFU treatment compared with those before operation 134.51(26.36)cm3,The index of 1,3,6 month were 87.97(12.73)cm3,69.04(23.72)cm3 and 40.69(21.64)cm3,respecti-vely.The difference was statistically significant;4 Hemoglobin content increased gradually after HIFU and anemia conditons was improved,datas compared with preoperative were statistically significant,and the scores were 80.9(9.33),103.2(8)and 109.9(12.78);5 The level of serum CA125 decreased after HIFU,which gradually became normal,which was statistically different from that before operation.The index of 1,3,6 month were 35.7(6.63),25.7(8.2)and 17.1(6.4),respectively;6 The scores of dysmenorrhea,mens-trual volume and hemoglobin were correlated with serum CA125 levels,and the correlation coefficients were0.399,0.561 and-0.88 respectively,which were statistically significant.Conclusion:1 HIFU treatment of adenomyosis,different clinical symptoms and serum CA125 decreased the difference was statistically significant,Serum CA125 can be used as an effective serological indicator for the clinical efficacy of HIFU in the treatment of adenomyosis;2 The results confirmed that HIFU for adenomyosis is safe and effective treatment,which can solve the patient dysmenorrhea,the amount of increased clinical symptoms such as the problem,eliminating the surgery and other invasive treatment,for the patient to retain the uterus,is a non-invasive,safe and effective New treatment. |
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