HIFU与UAE治疗不同分型子宫腺肌症的疗效分析

Curative effects of high-intensity focused ultrasound and uterine artery embolization in the treatment of diferent types of adenomyosis

目的分析讨论高强度聚集超声(HIFU)与子宫动脉栓塞术(UAE)治疗不同分型子宫腺肌症(AM)的疗效。方法将2020年4月至2022年3月沧州市人民医院收治的100例弥漫型AM患者与100例局限型AM患者作为研究对象。采用简单随机化法将100例弥漫型AM患者分为A组与B组,各50例;将100例局限型AM患者分为C组与D组,各50例。其中A组与C组予以HIFU治疗,B组与D组予以UAE治疗,四组治疗后均随访12个月。比较四组治疗后3、6个月病灶大小、月经量[采用月经失血图(PBAC)评估]、痛经程度[采用视觉模拟评分法(VAS)评估],比较四组治疗后12个月子宫体积、复发率,比较随访期间四组并发症发生率。结果四组患者治疗后3、6个月病灶大小、PBAC评分、VAS评分均低于治疗前,且A组低于同时期B组,C组低于同时期D组,C组低于同时期A组,D组低于同时期B组(P<0.05)。治疗后12个月,四组患者子宫体积均低于治疗前,且A组低于同时期B组,C组低于同时期D组,C组低于同时期A组,D组低于同时期B组(P<0.05)。治疗后12个月,A组复发率低于B组,C组低于D组,C组低于A组,D组低于B组,但差异无统计学意义(P>0.05)。随访期间,A组与B组、C组与D组、A组与C组、B组与D组间并发症总发生率差异无统计学意义(P>0.05)。结论HIFU与UAE在不同分型AM中均具有良好治疗效果,且安全性良好,但HIFU临床效果更显著,同时在治疗弥漫型AM中能有效降低患者复发率。

Objective To analyze and discuss the curative effects of high-intensity focused ultrasound(HIFU)and uterine artery embolization(UAE)in the treatment of different types of adenomyosis(AM).Methods A total of 100 patients with diffuse AM and 100 patients with localized AM admitted to Cangzhou People′s Hospital from April 2020 to March 2022 were selected as research subjects,100 patients with diffuse AM were divided into group A and group B with 50 cases in each group,and 100 patients with localized AM were classified into group C and group D with 50 cases in each group by simple randomization method.Group A and group C were treated with HIFU,and group B and group D were treated with UAE,and all four groups were followed up for 12 months after treatment.The lesion size,menstrual volume[pictorial blood loss assessment chart(PBAC)evaluation]and dysmenorrhea degree[visual analogue scale(VAS)evaluation]at 3 months and 6 months after treatment,uterine volume and recurrence rate at 12 months after treatment and incidence rates of complications during follow-up were compared among the four groups.Results Lesion size,PBAC score and VAS score in the four groups at 3 months and 6 months after treatment were all lower than those before treatment,and the above indicators were lower in group A than group B,lower in group C than group D,lower in group C than group A,and lower in group D than group B during the same period(P<0.05).At 12 months after treatment,the uterine volume in the four groups was less than that before treatment,and the uterine volume was less in group A than group B,less in group C than group D,less in group C than group A,and was less in group D than group B during the same period(P<0.05).At 12 months after treatment,the recurrence rate in group A was lower than that in group B,lower in group C than group D,lower in group C than group A,and was lower in group D than group B,but with no statistically significant differences(P>0.05).During follow-up,there were no statistically significant differences in the total incidence rate of complications between group A and group B,between group C and group D,between group A and group C and between group B and group D(P>0.05).Conclusions HIFU and UAE have good therapeutic effects and good safety on different types of AM,but HIFU has more significant clinical effect and can effectively reduce the recurrence rate of patients in the treatment of diffuse AM.