The Comparision Of Safety And The Evaluation Of The Effectiveness With Ultrasound Ablation In The Treatment Of Uterine Adenomyoma

Objective: To evaluate the safety and efficacy of ultrasound guided ultrasound ablationfor uterine adenomyoma and laparoscopic myomectomy in treatment of uterineadenomyoma.Methods: According to include and exclude criteria，79cases of hospitalized patients（84adenomyomas）diagnosed with uterine adenomyoma in the first affiliated hospitalof Wannan medical college since July2012to July2013were set as the experimentalgroup，which randomly divided into two groups:1）HIFU group，37patients（37adenomyomas）were treated with the HIFU JC focused ultrasound tumor therapeuticsystem (Chongqing Hafu Technology Co.,Ltd.,China). Ultrasound ablation wasperformed guided by ultrasonography under conscious sedation for one-single session.2）Laparoscope group，42patients（47adenomyomas）were treated with laparoscopicresecting the regional lesions. Another normal control group paralleled to theexperimental group were60patients diagnosed with ovarian follicular cyst, fallopiantubal recanalization, CIN Ⅲfor the same period. Study followed up for6months. Theevaluation indices as follows: ablated area ratio and volume reduction ratio of targetadenomyomas, and symptoms improvement of patients. Compared uterine volumereduction ratio of the HIFU group with the laparoscope group after treat. Analyzesthe correlation between the laboratory index and symptoms of AM.Results:1)100.00%of patients (all the37cases in HIFU group) have clinically significant effects, with a more than50%volume reduction in35treated fibroids. Theaverage reduction in fibroid volume determined at6months after HIFU treatment andoperation treatment shows: it is no significant difference between two differenttreatment groups (P>0.05).2) Symptoms and the quality of life can be obviouslyimproved after HIFU treatment, the difference is statistically significant(P<0.01).Compared with two treatment groups in symptom and quality of life score, thedifference is no significant (P>0.05).3) Comparing of patients’ adverse reaction in twogroups after treatment, the incidence rate in HIFU group was significantly lower thanthe laparoscope group, and the difference was statistically significant (P<0.05).4) Highlevel substance P and low level hemoglobin in adenomyoma group, compared to normalcontrol group, both had statistical significance (P <0.01). The alteration of substance Pand hemoglobin contents in blood analysed at6months after treatment, the comparisonbetween two different treatments has no obvious statistical significance (P>0.05).Conclusion:1)Ultrasound ablation treatment of uterine adenomyoma and operationtreatment can achieve equivalent efficacy，with more security, which can be used totreat uterine adenomyoma.2) Substance P may induce dysmenorrhea symptoms inuterine adenomyoma, which analyzed in blood levels associated with the degree ofdysmenorrhea.