Effect Of High Intensity Focused Ultrasound(HIFU)on Coagulation And Fibrinolytic System In The Treatment Of Uterine Leiomyomas Or Adenomyosis

Objective: To probe the effect of high-intensity focused ultrasound(HIFU)on coagulation and fibrinolytic system in the treatment of uterine leiomyomas or adenomyosis.Method: From April 2018 to November 2018,the selected objects was 112 patients with uterine leiomyomas and adenomyosis who were confirmed by clinical and imaging examination and underwent the therapy of HIFU in the Department of Obstetrics and Gynecology,Affiliated Hospital of North Sichuan Medical College.According to the different types of diseases,there were 72 uterine leiomyomas and 40 adenomyosis.The venous blood samples was taken from the elbow fossa 24 hours before surgery and 24 hours after surgery respectively.PT,APTT,TT,FIB,D-D,FDP and PLT were measured in the laboratory of the Affiliated Hospital of North Sichuan Medical College.The changes from the postoperative to preoperative detection indexes were compared between two groups and within the group.Result:1.In the group of uterine leiomyoma,postoperative PT and TT were longer than those before the operation and the differences were statistically significant(P<0.05);The APTT was shorter than that before the operation and the differences were statistically significant(P< 0.05);The FIB decreased after the operation,however D-D and FDP increased apparently after the operation and the differences were statistically significant(p<0.05);There was no statistically significant difference in the PLT between the postoperative and preoperative(P>0.05).2.In the group of adenomyosis,postoperative PT and TT were longer than those before the operation and the differences were statistically significant(P<0.05);The APTT was shorter than that before the operation and the differences were statistically significant(P<0.05);The FIB decreased after the operation,however D-D and FDP increased apparently after the operation and the differences were statistically significant(P<0.05);There was no statistically significant difference in the PLT between the postoperative and preoperative(P>0.05).3.The D-D,FIB and PLT in the group of adenomyosis were higher than uterine leiomyomas,the difference was statistically significant(P< 0.05);In postoperative,PLT in the group of adenomyosis was apparently lower than uterine leiomyomas,and the difference was statistically significant(P<0.05).Conclusions:1.Coagulation changes after HIFU treatment might be related to HIFU treatment leading to tissue and vascular injury,activation of coagulation system,and activation of fibrinolysis system.2.After HIFU treatment,the APTT was shortened,the blood was in a state of easily coagulating,and there was a risk of thrombosis,but the detection value was still within the normal range,and actually there was not the increased risk of thrombosis.3.After HIFU treatment,the PT and TT was prolonged,the FIB was decreased,FDP and D-D was increased,and the risk of bleeding increased,but there was no surgical "wound",which actually did not increase the risk of bleeding.