| Objective To evaluate the clinical efficacy and safety of high intensity focused ultrasound(HIFU)combined with Gn RH-a treating for adenomyosis and to analyze the influence of patient's age and course on clinical results.Methods 61 patients with adenomyosis who treated in the Anhui Provincial Hospital were selected from December 2014 to January 2016,and all of patients the principal symptom were the dysmenorrhea and has fertility requirements.31 cases who were treated with HIFU combined with Gn RH-a were experience group,and 30 cases who were only treated with HIFU were control group,and to evaluate the improvement of symptoms and the recurrence rate at 6,12 months after operation.Dysmenorrhea scores,menstrual blood volume,reduction rate of uterus size CA125 value,adverse reactions andpregnancy results of the 1,6 and 12 months after operation was compared in 2 groups.The experience group was divided into 2 subgroups by(age>38or?38)and(course>4or?4),To compare dysmenorrhea scores and menstrual volume decline,reduction rate of uterus size in the two subgroups.Results The total effective rate of dysmenorrhea relief and the total improvement rate of menstrual blood volume relief respectively were 79.31%(23/29)and 70.37%(19/27)at 6 months and respectively were 73.08%(19/26)and 70.83%(17/24)at 12 months after the operation in the control group.The total effective rate of dysmenorrhea relief and the total improvement rate of menstrual blood volume relief respectively were 96.77%(30/31)and 92.86%(26/28)at 6 months and respectively were 89.29%(25/28)and 92.31%(24/26)at 12 months after the operation in the experimental group,which was significantly higher than that of the control group.The recurrence rate of the control group was 19.23%(5/26).The recurrence rate of the experimental group was7.14%(2/28),which was significantly lower than the control group,and the recurrence time of the experimental group was delayed.At 6,12 months,after operation,the menstrual blood volume,reduction rate of uterus size and CA125 value of the experimental group was lower than those of the control group.The rate of uterus volume reduction was higher than the control group,and the difference was statistically significant(P<0.05).There were no serious adverse reactions in the two groups.There were 2 pregnant women in the control group,and 4 pregnant women in the experimental group.The number of pregnancies in the experimental group was higher than that in the control group.Scores were decreased and uterine size were significantly higher in the experimental subgroups(age>38)dysmenorrhea than the experimental subgroups(age?38).Hypermenorrhea scores and menstrual volume decline in the experimental subgroup(course>4)were significantly higher than the experimental subgroups(course?4),the difference was statistically significant(P< 0.05).There were no serious adverse reactions in the two groups.Conclusion HIFU combined with Gn RH-a treatment is preferable to HIFU treatment,which can reduce the recurrence rate,delays the recurrence,and more be suitable for older,longer course patients with adenomyosis.The two methods are safe and effective. |
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