High-intensity focused ultrasound (HIFU) combined with gonadotropin-releasing hormone analogs (GnRHa) and levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis: a case series with long-term follow up
High-intensity focused ultrasound (HIFU) combined with gonadotropin-releasing hormone analogs (GnRHa) and levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis: a case series with long-term follow up
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DOI：
10.1080/02656736.2019.1679892
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发表时间：
2019-01-01
影响因子：
3.1
通讯作者：
Wei Wang
中科院分区：
文献类型：
--
作者：
Sun Haiyan;Wang Lin;Wei Wang
目的：本研究旨在评估高强度聚焦超声（HIFU）消融、促性腺激素释放激素类似物（GnRHa）和左炔诺孕酮宫内释放系统（LNG-IUS）联合治疗子宫腺肌病（AD）的长期结局。研究方法：入选142例AD患者，接受HIFU保守治疗联合GnRHa和LNG-IUS辅助治疗。所有病例均随访至治疗后5年。测量子宫体积、AD病变体积、月经量和痛经评分。记录术后复发率和并发症发生率。结果：治疗后子宫体积和病变体积均明显缩小。治疗后子宫体积逐渐缩小，治疗后12个月达到最低水平122.07 +/-44.12 cm（3），平均缩小率为45%，之后略有增加，与基线水平相比保持约35%的缩小率。AD病变体积、痛经评分和月经量也出现类似的减少。血红蛋白水平升高。长期复发率较低，痛经和月经过多的复发率分别为5.68%和7.91%。未报告严重并发症或不良事件。结论：HIFU消融术联合GnRHa和LNG-LUS治疗子宫腺肌病可能是一种安全有效的替代方法。
Objective: This research was conducted to assess the long-term outcomes of a combination treatment of High-intensity focused ultrasound (HIFU) ablation, gonadotropin-releasing hormone analogs (GnRHa) and Levonorgestrel-releasing intrauterine system (LNG-IUS) for women with adenomyosis (AD). Methods: One hundred and forty-two patients with AD were enrolled and treated with HIFU conservative treatment in combination with adjuvant therapy of GnRHa and LNG-IUS. All the cases were followed up to 5 years after treatment. The volumes of uteri, AD lesions, and menstrual blood, and dysmenorrhea scores were measured. Also, the incidences of recurrence and complications were recorded. Results: Both the uterine and lesion volumes significantly decreased after treatment. The uterine volume gradually reduced after treatment, reaching the lowest level of 122.07 +/- 44.12 cm(3) at 12 months after treatment, with an average reduction rate of 45%, and then increased slightly, maintaining a reduction rate of about 35% compared with the baseline level. Similar decreases in AD lesion volumes, dysmenorrhea scores, and menstrual flow were also demonstrated. Hemoglobin levels increased. Moreover, the long-term recurrence rates were low, with 5.68% and 7.91% in dysmenorrhea and menorrhagia, respectively. No serious complications or adverse events were reported. Conclusions: HIFU ablation, in combination with GnRHa and LNG-LUS, might be a safe and effective alternative in the treatment for women with adenomyosis.