The Clinical Effect Of Microwave Ablation Combined With Mirena In The Treatment Of Adenomyosis

Objective To investigate the clinical effect of microwave ablation combined with Mirena in the treatment of adenomyosis.Methods From 2019 to 2020,60 cases of adenomyosis who were required to retain uterine treatment in Cardiovascular and Cerebrovascular Disease Hospital of Ningxia Medical University General Hospital.Patients were Divided into two groups according to the patient ’s condition assessment and willingness.The observation group was microwave ablation combined with Mirena,and the control group was laparoscopic lesion resection combined with Mirena,30 cases in each group.SPSS26.0 software was used to analyze the differences in dysmenorrhea score,menstrual volume score,hemoglobin(Hb),serum carbohydrate antigen 125(CA125),uterine volume reduction rate,lesion reduction rate,symptom and health-related quality of life questionnaire score,as well as the differences in operation time,intraoperative bleeding,intraoperative complications and hospitalization time,postoperative pain score,postoperative complications and recurrence.Results 1.Common data : There was no significant difference in age,course of disease,pregnancy history and uterine position between the two groups(P > 0.05).2.The clinical symptoms of patients with adenomyosis were significantly relieved by the two methods.The total effective rate of the observation group was 96.67 %,and the total effective rate of the control group was 100 %,The difference was not statistically significant(P > 0.05).2.1 Dysmenorrhea score : The dysmenorrhea scores of the two groups after operation were significantly lower than those before treatment(P < 0.05),and the dysmenorrhea score of the observation group was higher after 1 month(P < 0.05).There was no significant difference between the two groups at 3,6,9 and 12 months after operation(P > 0.05).2.2 Menstrual volume score : The postoperative menstrual volume score of the two groups was significantly lower than that before treatment(P < 0.05),and the higher in the observation group at 1 and 3 months after operation(P < 0.05).There was no significant difference between the two groups at 6,9 and 12 months after operation(P > 0.05).2.3 Hemoglobin(Hb): The postoperative Hb of the two groups was not statistically significant(P > 0.05).2.4 Serum CA125 : The serum CA125 of the two groups after operation was significantly lower than that before operation(P < 0.05),and the difference between the two groups was not statistically significant(P > 0.05).2.5 Uterine volume reduction rate and lesion reduction rate2.5.1 Uterine volume reduction rate : The uterine volume reduction rate of the two groups was gradually increased(P < 0.05).The uterine volume reduction rate of the observation group was smaller,and the difference between the groups was statistically significant(P < 0.05).2.5.2The lesion reduction rate :The volume of lesions in the two groups decreased after operation,and the lesions in the observation group decreased gradually.The reduction rate of lesions was 55.16 % at 1 month after operation,75.92 % at 6 months after operation,and77.16 % at 1 year after operation.The difference was statistically significant(P < 0.05).The lesion reduction rate of the control group was basically close to 100 % at 1 month after operation,and it was basically unchanged every month after operation.There was no significant difference within the group(P > 0.05);The difference between the two groups was statistically significant(P < 0.05).2.6 The uterine fibroid sympom and quality of life2.6.1 Symptom score(UFS score): The postoperative UFS scores of the two groups were lower than those before treatment(P < 0.05),and there was no significant difference between the two groups(P > 0.05).2.6.2 Health-related quality of life score(HRQL score): The postoperative HRQL scores of the two groups were higher than those before treatment(P < 0.05),and the difference between groups was not statistically significant(P > 0.05).3.Compared with the control group,the observation group had short operation time,less intraoperative bleeding and short average hospitalization time,and the difference was statistically significant(P < 0.05).4.Postoperative pain score(VAS score): There was no significant difference in pain score between the two groups at 2 hours after operation(P > 0.05).The pain score of the observation group was lower from 6 hours to 1 month after operation(P < 0.05).5.Complication5.1 Intraoperative complications: There was no damage to important organs such as intestine,bladder and ureter during operation in both groups.5.2 Postoperative complication : vaginal discharge in the observation group was more than that in the control group(P < 0.05),vaginal bleeding and gastrointestinal distention were less than those in the control group(P < 0.05).There was no significant difference in fever and amenorrhea between the two groups(P > 0.05).No serious complications occurred in the two groups.6.Recurrence rate : There was no recurrence in the two groups within 9 months after operation,and 3 cases of recurrence in the observation group were followed up to 1 year,the recurrence rate was 10 %;There were 4 cases of recurrence in the control group,and the recurrence rate was 13.33 %.There was no significant difference in the recurrence rate between the two groups(P > 0.05).Conclusion 1.Microwave ablation combined with Mirena has good short-term clinical efficacy in the treatment of adenomyosis,which is equivalent to laparoscopic lesion resection combined with Mirena.2.Microwave ablation combined with Mirena is safe and minimally invasive in the treatment of adenomyosis.The operation time,intraoperative blood loss,hospitalization time,postoperative pain and adverse reactions are better than those of laparoscopic lesion resection combined with Mirena.3.Microwave ablation combined with adenomyosis therapy had a low recurrence rate 1year after operation.which was not different from that of laparoscopic lesion resection combined with Mirena.