Observation Of The Effect Of High Intensity Focused Ultrasound(HIFU)Combined With Drugs In The Treatment Of Adenomyosis

Objective: To evaluate the efficacy and safety of high intensity focused ultrasound(HIFU)combined with different drugs in the treatment of adenomyosis.Methods: Collected 96 cases of patients with adenomyosis,were randomly divided into HIFU group,HIFU+Mirena group,HIFU+mifepristone group,HIFU+Gn RH-a group 4 groups,each group of 24 cases.HIFU group without any drugs,pure HIFU treatment.HIFU+ Mirena: in the Mirena group after about 1-2 weeks,at the end of the acute inflammatory reaction,menstrual period in 2-7 days,the Mirena intrauterine implantation.Group HIFU+mifepristone: HIFU+mifepristone group was treated with mifepristone10 mg orally 1 months before or after HIFU operation,with a daily dose of 1times.Group HIFU+GnRH-a: 1 months before surgery or after the start of treatment,menstrual cramps in 1~3days GnRH-a needle 3.75 mg,every 4weeks for 1 time.The changes of dysmenorrhea score,volume score,uterine volume,serum CA125 level and uterine artery blood flow Vmax,Vmin,RI were compared between the groups before and after 3 months,at the end of the 6 month,and at the end of the 12 months.Results: The four groups after 3 months,6 months and 12 months,the dysmenorrhea score,volume score,uterine volume,serum CA125 level and uterine artery blood flow Vmax,Vmin,RI were significantly decreased(P<0.05),the other three groups,HIFU+ Mirena group,HIFU+ mifepristone group,HIFU+GnRH-a group,after 3 months?6 months and 12 months,the dysmenorrhea score,volume score,uterine volume,serum CA125 level and uterine artery blood flow Vmax,Vmin,RI had no significant difference(P>0.05),but were significantly lower than HIFU group,the difference was statistically significant(P<0.05).There was no significant difference in theincidence of adverse reactions between the four groups(P>0.05).Conclusion: HIFU combined with LNG-IUS,mifepristone,GnRH-a can obviously improve the symptoms of patients,improve the hemodynamics,uterine efficacy,and adverse reactions were not significantly increased,which is worthy of clinical promotion.