| Objective:To discuss the effect of HIFU combined with GnRH-a and LNG-IUS for the shake of improving clinical curative effect on patients who have adenomyosis.Methods:186 patients diagnosed as adenomyosis in Northwest Women and Children Hospital from January 2019 to December 2020 were collected.Ten people were excluded,and finally 176 people were included in the study for retrospective analysis.According to different treatment methods,they were divided into HIFU group(60 cases),HIFU+GnRH-a group(60 cases),HIFU+GnRH-a+LNG-IUS group(56 cases).The basic data of three groups were collected,and the VAS score,PBAC score,uterine volume change and quality of life score of each group were followed up and the curative effect was analyzed.Results:1.VAS score:3 months,9 months and 12 months after operation,the VAS score of Group A was statistically significant compared with that before operation(P<0.05);At 9months and 12 months after operation,the VAS scores of Group B and Group C were statistically significant compared with those before operation(P<0.05);At 9 months and12 months after operation,there were significant differences between Group B and Group C and Group A(P<0.05);There was significant difference between Group C and Group B(P<0.05).2.PBAC score:3 months,9 months and 12 months after operation,the PBAC score of Group A was statistically significant compared with that before operation(P<0.05);After 9 months and 12 months,the PBAC scores of Group B and Group C were statistically significant compared with those before operation(P<0.05);At 9 months and12 months after operation,there were significant differences between Group B and Group C and Group A(P<0.05);There was significant difference between Group C and Group B(P<0.05).3.Changes of uterine volume:3 months,6 months and 12 months after operation,the uterine volume in Group A Group B and Group C were statistically significant compared with those before operation(P<0.05);There were significant differences between Group B,Group C and Group A(P<0.05);There was significant difference between Group C and Group B(P<0.05).4.Quality of life score:Group A,Group B and Group C were statistically significant compared with those before operation(P<0.05);there were significant differences between Group B and Group C and Group A(P<0.05);The quality of life scores of Group B and Group C were statistically significant(P<0.05).5.1-year postoperative effective rate:3 groups 1-year postoperative effective rateχ~2test(χ~2=6.214,P<0.05),so it can be considered that 3 groups 1-year postoperative effective rate is different.6.Postoperative fertility statistics:In Group A,60 cases,15 cases had fertility requirements,and 5 cases were pregnant within one year after operation,with a pregnancy rate of 33.3%;Of the 60 cases in Group B,47 had fertility requirements,and20 were pregnant within one year after operation,with a pregnancy rate of 42.5%.Conclusion:1.HIFU is effective in treating adenomyosis,and it is worth popularizing in clinic.2.HIFU combined with GnRH-a,HIFU combined with GnRH-a and LNG-IUS are superior to HIFU treatment group in relieving menstrual pain,reducing menstrual volume,reducing uterine volume and improving quality of life.3.The therapeutic effect of HIFU combined with GnRH-a and LNG-IUS on adenomyosis is better than that of HIFU combined with GnRH-a.4.HIFU combined with GnRH-a may have an advantage over HIFU in improving the pregnancy rate of adenomyosis patients with fertility requirements. |
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