本文選題：子宮腺肌癥 + 高強(qiáng)度聚焦超聲　； 參考：《安徽醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的探討高強(qiáng)度聚焦超聲(HIFU)聯(lián)合促性腺激素釋放激素激動(dòng)劑(GnRH-a)治療子宮腺肌癥的臨床療效并分析患者年齡和病程對(duì)其療效的影響。方法選取2014年12月至2016年1月在安徽省立醫(yī)院確診為子宮腺肌癥的患者61例,均以痛經(jīng)為主要癥狀且有生育要求,其中31例為實(shí)驗(yàn)組行HIFU聯(lián)合GnRH-a治療,30例為對(duì)照組行單純HIFU治療,評(píng)價(jià)兩組患者術(shù)后6、12個(gè)月時(shí)的癥狀改善情況及復(fù)發(fā)率,對(duì)比研究術(shù)后1、6、12個(gè)月的痛經(jīng)評(píng)分、月經(jīng)量評(píng)分、子宮體積縮小率、糖類(lèi)抗原125(CA125)值的變化以及不良反應(yīng)、妊娠情況。將實(shí)驗(yàn)組以年齡38歲與≤38歲及病程4年與≤4年分別分為兩組,比較兩組的痛經(jīng)及月經(jīng)量評(píng)分下降程度、子宮體積縮小率。結(jié)果對(duì)照組術(shù)后6個(gè)月痛經(jīng)及月經(jīng)改善總有效率分別為79.31%(23/29)及70.37%(19/27)、術(shù)后12個(gè)月分別為73.08%(19/26)及70.83%(17/24),實(shí)驗(yàn)組術(shù)后6個(gè)月痛經(jīng)及月經(jīng)改善總有效率分別為96.77%(30/31)及92.86%(26/28)、術(shù)后12個(gè)月分別為89.29%(25/28)及92.31%(24/26),均明顯高于對(duì)照組。對(duì)照組復(fù)發(fā)率19.23%(5/26),實(shí)驗(yàn)組復(fù)發(fā)率7.14%(2/28),實(shí)驗(yàn)組明顯低于對(duì)照組,復(fù)發(fā)時(shí)間亦較其延遲。兩組間術(shù)后6個(gè)月和12個(gè)月,實(shí)驗(yàn)組痛經(jīng)評(píng)分、月經(jīng)量評(píng)分、CA125水平均明顯低于對(duì)照組,子宮體積縮小率明顯高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組均無(wú)嚴(yán)重的不良反應(yīng)發(fā)生。對(duì)照組妊娠2例,實(shí)驗(yàn)組妊娠4例,實(shí)驗(yàn)組高于對(duì)照組。實(shí)驗(yàn)組年齡38歲患者痛經(jīng)評(píng)分下降及子宮體積縮小程度高于年齡≤38歲患者,病程4年患者痛經(jīng)及月經(jīng)量評(píng)分下降程度高于病程≤4年患者,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。逡逡結(jié)論單純HIFU治療及HIFU聯(lián)合GnRH-a治療子宮腺肌癥均安全有效,聯(lián)合GnRH-a治療較單純HIFU治療療效更確切,可減少?gòu)?fù)發(fā)率,延遲復(fù)發(fā),且更適用于年齡較大、病程較長(zhǎng)的子宮腺肌癥患者。
[Abstract]:Objective to investigate the clinical effect of high intensity focused ultrasound (HIFU) combined with gonadotropin releasing hormone agonist (GnRH-a) in the treatment of adenomyosis. Methods from December 2014 to January 2016, 61 cases of adenomyosis were diagnosed in Anhui Provincial Hospital. Dysmenorrhea was the main symptom and had fertility requirement. Among them, 31 cases were treated with HIFU combined with GnRH-a in the experimental group and 30 cases were treated with HIFU alone in the control group. The symptom improvement and recurrence rate of the two groups were evaluated at 6 and 12 months after operation. The scores of dysmenorrhea and menstrual volume at 1 and 12 months after operation were compared. Uterine volume reduction rate, carbohydrate antigen 125 CA125), adverse reactions, pregnancy. The experimental group was divided into two groups according to the age of 38 years or less than 38 years, the course of disease and the duration of 4 years and 鈮，

本文編號(hào)：1897668