Clinical Study of High-Intensity Focused Ultrasound Combined with Endome-trial Thermal Balloon Ablation for the Treatment of Menorrhagia Associated with Adenomyosis
- VernacularTitle:高强度聚焦超声联合热球子宫内膜消融治疗子宫腺肌病相关月经过多的临床研究
- Author:
Dan WANG
1
,
2
;
Zhuoting JIN
;
Ligang WANG
;
Jia GE
;
Yong ZHANG
Author Information
1. 电子科技大学医学院附属绵阳医院·绵阳市中心医院妇产科,四川 绵阳 621000
2. 重庆医科大学超声医学工程国家重点实验室,重庆 400016
- Keywords:
Adenomyosis;
High-intensity focused ultrasound ablation;
Thermal balloon endometrial ablation;
Gonadotropin-releasing hormone agonist;
Levonorgestrel-releasing intrauterine system
- From:
Journal of Practical Obstetrics and Gynecology
2024;40(7):560-565
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy and safety of high intensity focused ultrasound(HIFU)com-bined with endometrial thermal Balloon ablation(TBEA)in the treatment of menorrhagia associated with adenomy-osis(AM).Methods:A retrospective cohort study was performed on clinical data of 77 patients with menorrhagia associated with adenomyosis(AM)in Mianyang Central Hospital from January 2021 to December 2022.According to different treatment methods,they were divided into HIFU combined with TBEA(HIFU+TBEA group,n=26)and HIFU combined with gonadotropin-releasing hormone agonist(GnRH-a)and levonorgestrel-releasing intrauterine system(LNG-IUS)(HIFU+drug group,n=51).The pictorial blood loss assessment chart(PBAC)at different fol-low-up time after HIFU ablation was used as the main outcome index,dysmenorrhea score(NRS),serum CA125 level,re intervention rate,treatment effectiveness rate and adverse reactions were used as the secondary out-come indexes.Evaluate the efficacy and safety of HIFU combined with TBEA in the treatment of menorrhagia as-sociated with AMby comparing the difference of outcome indexes between two groups before and after treatment at different times.Results:Compared with pre-treatment,the PBAC score,NRS score and CA125 level were signif-icantly decreased after treatment in both groups(P<0.05).Compared with HIFU+drug group,PBAC score of HIFU+TBEA group decreased more at 6,9 and 12 months after treatment(P<0.05),but there was no signifi-cant difference in PBAC score at 1 and 3 months after treatment(P>0.05).There was no significant difference in NRS scores between the two groups at 1,3,6,9 and 12 months after treatment(P>0.05).There was no signifi-cant difference in reintervention rate between HIFU+TBEA group(11.54% )and HIFU+drug group(21.57% )after treatment(P>0.05).There was no significant difference in treatment effectiveness between HIFU+TBEA group(80.77% )and HIFU+drug group(70.59% )(P>0.05).The adverse reactions of the two groups after treatment were graded as SIR A-B,and no serious adverse events occurred.Conclusions:The combination of HIFU and TBEA has good efficacy and safety in the treatment of AM,and can be used as a long-term manage-ment program for patients with no fertility needs,especially for AM patients with menorrhagia,which also has good clinical application value.
