[1]王 艺,王世进,郭会敏.高强度聚焦超声技术和促性腺激素释放激素激动剂单独或联合治疗子宫腺肌瘤的临床疗效[J].新乡医学院学报,2021,38(3):285-288.[doi:10.7683/xxyxyxb.2021.03.017]
 WANG Yi,WANG Shijin,GUO Huimin.Clinical efficacy of high-intensity focused ultrasound technology and gonadotropin releasing hormone agonist alone or combination therapy in patients with adenomyoma[J].Journal of Xinxiang Medical University,2021,38(3):285-288.[doi:10.7683/xxyxyxb.2021.03.017]
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高强度聚焦超声技术和促性腺激素释放激素激动剂单独或联合治疗子宫腺肌瘤的临床疗效
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年3
页码:
285-288
栏目:
临床研究
出版日期:
2021-03-05

文章信息/Info

Title:
Clinical efficacy of high-intensity focused ultrasound technology and gonadotropin releasing hormone agonist alone or combination therapy in patients with adenomyoma
作者:
王 艺王世进郭会敏
(新乡医学院第一附属医院妇科, 河南 卫辉 453100)
Author(s):
WANG YiWANG ShijinGUO Huimin
(Department of Gynecology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)
关键词:
高强度聚焦超声促性腺激素释放激素激动剂子宫腺肌瘤
Keywords:
high-intensity focused ultrasoundgonadotropin releasing hormone agonistadenomyoma
分类号:
R711.74
DOI:
10.7683/xxyxyxb.2021.03.017
文献标志码:
A
摘要:
目的 探讨高强度聚焦超声(HIFU)技术单独或联合促性腺激素释放激素激动剂(GnRH-a)治疗直径较大的子宫腺肌瘤的临床疗效。方法 选择2016年6月至2018年6月于新乡医学院第一附属医院收治的90例子宫腺肌瘤4~7 cm的患者为研究对象,根据治疗子宫腺肌瘤的方案分为HIFU组、GnRH-a组、GnRH-a+HIFU组,每组30例。比较3组患者治疗前和治疗后3、6、12个月的病灶体积、痛经视觉模拟评分(VAS)、月经失血图(PBAC)评分及外周静脉血中糖类抗原125水平。结果 治疗前,3组患者的病灶体积、痛经VAS评分、PBAC评分及外周静脉血中糖类抗原125水平比较差异无统计学意义(P>0.05)。治疗后3、6、12个月,3组患者的病灶体积、痛经VAS评分、PBAC评分及外周静脉血中糖类抗原125水平均小于治疗前(P<0.05)。治疗后3、6、12个月,HIFU+GnRH-a组患者的病灶体积、痛经VAS评分、PBAC评分、外周静脉血中糖类抗原125水平均显著小于HIFU 组和GnRH-a 组(P<0.05)。结论 HIFU和GnRH-a单独或联合治疗子宫腺肌瘤均安全有效,对于子宫腺肌瘤直径4~7 cm的患者采用GnRH-a和 HIFU联合治疗效果更佳。
Abstract:
Objective To investigate the clinical efficacy of high-intensity focused ultrasound (HIFU) technology and gonadotropin releasing hormone agonist (GnRH-a) alone or combination therapy in patients with larger diameter adenomyoma.Methods  Ninety patients with adenomyoma with diameter of 4-7 cm admitted to the First Affiliated Hospital of Xinxiang Medical University from June 2016 to June 2018 were selected as the research objects,and they were divided into the HIFU group,GnRH-a group,GnRH-a+HIFU group according to the treatment plan of adenomyoma,30 cases in each group.The lesion volume,visual analogue score (VAS) of dysmenorrhea,Pictorial blood loss assessment chart (PBAC) score and carbohydrate antigen 125 value in peripheral venous blood of patients before treatment and 3,6,12 months after treatment were compared among the 3 groups.Results Before treatment,there was no significant difference in the lesion volume,VAS score of dysmenorrhea,PBAC score and carbohydrate antigen 125 value in peripheral venous blood of patients among the three groups (P>0.05).The lesion volume,VAS score of dysmenorrhea,PBAC score and carbohydrate antigen 125 value in peripheral venous blood of patients at 3,6,12 months after treatment were lower than those before treatment in the 3 groups(P<0.05).At 3,6,12 months after treatment,the lesion volume,VAS score of dysmenorrhea,PBAC score and carbohydrate antigen 125 value in peripheral venous blood of patients in the HIFU+GnRH-a group were significantly lower than those in the HIFU group and GnRH-a group (P<0.05).Conclusion HIFU and GnRH-a alone or in combination therapy are safe and effective in the patients with adenomyoma .For patients with adenomyoma with diameter of 4-7 cm,the combined treatment of GnRH-a and HIFU has a better effect.

参考文献/References:

[1] 钟婷婷.子宫腺肌病痛经的发病机制概述[J].嘉应学院学报,2016,34(8):83-86.
[2] 桂涛,黄美华,朱利,等.子宫腺肌病发病机制研究新进展[J].实用医学杂志,2015,31(16):2754-2756.
[3] 王智彪,郎景和.高强度聚焦超声消融与子宫腺肌病[J].中华妇产科杂志,2016,51(9):201-204.
[4] 张宁.促性腺激素释放激素激动剂在妇产科的应用研究进展[J].中国现代药物应用,2018,12(19):205-207.
[5] 中华医学会.临床诊疗指南:妇产科学分册[M].北京:人民卫生出版社,2007:70-85.
[6] 方淑芬,万玉珍.不同种类CA125浓度测量值对子宫内膜异位症与子宫腺肌症的鉴别诊断价值[J].中国现代医生,2018,56(21):59-63.
[7] GURIAN M B,MITIDIERI A M,ROSA E SILVA J C,et al.Measures used to assess chronic pelvic pain in randomized controlled clinical trial:a systematic review[J].J Eval Clin Pract,2015,21(4):749-756.
[8] 冯力民,夏恩兰,黄晓武,等.应用月经失血图评估月经血量[J].中华妇产科杂志,2001,36(1):51.
[9] 谢红莉,尤玉晓,冯乔,等.高强度聚焦超声联合小剂量米非司酮在子宫腺肌病治疗中的临床价值[J].临床合理用药杂志,2015,8(34):86-87.
[10] SOFUNI A,MORIYASU F,SANO T,et al.Safety trial of high-intensity focused ultrasound therapy for pancreatic cancer[J].World J Gastroenterol,2014,20(28):9570-9577.
[11] 王瑞歌,王世进.促性腺激素释放激素激动剂联合高强度聚焦超声治疗子宫腺肌病疗效观察[J].新乡医学院学报,2017,34(6):529-531.
[12] LEE J S,HONG G Y,LEE K H,et al.Changes in anti-müllerian hormone levels as a biomarker for ovarian reserve after ultrasound-guided high-intensity focused ultrasound treatment of adenomyosis and uterine fibroid[J].BJOG,2017,124(Suppl 3):18-22.
[13] 李梦如,陈欢,张红,等.GnRHa与子宫腺肌症相关研究进展[J].中国性科学,2018,27(7):79-82.
[14] GUO Y,DUAN H,CHENG J,et al.Gonadotrophin-releasing hormone agonist combined with high-intensity focused ultrasound ablation for adenomyosis:a clinical study[J].BJOG,2017,124(Suppl 3):7-11.

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更新日期/Last Update: 2021-03-05