Abstract

Objective

To investigate the long-term clinical outcomes of patients with adenomyosis treated by high-intensity focused ultrasound (HIFU).

Materials and methods

From June 2012 to January 2020, 2311 patients with adenomyosis were treated with HIFU at our center, 1982 patients who have complete clinical data were retrospectively reviewed. Among the patients who completed the follow-up, 485 were treated with HIFU alone, 289 were treated with HIFU followed by GnRH-a, 255 were treated with HIFU combined with Mirena and 594 were treated with HIFU combined with GnRH-a and Mirena. The dysmenorrhea severity pain score and average menorrhagia severity score before and at 3 months, 6 months, 1 year, 2 years, 3 years and 5 years after HIFU were compared. The adverse effects were recorded. In addition, the efficacy between patients treated with GnRH-a and/or Mirena were compared.

Results

After HIFU ablation, the dysmenorrhea severity pain score and the menorrhagia severity score were significantly decreased at each follow-up time point. However, it was observed that as the follow-up time increased, the effective rate of HIFU treatment in improving dysmenorrhea and menorrhagia decreased. The 6 months and 3 years follow-up results showed that the efficacy of HIFU combined with Mirena and HIFU combined with GnRH-a and Mirena were significantly higher than HIFU alone and HIFU combined with GnRH-a (p < 0.05). The major complications were rare.

Conclusion

HIFU is a safe and effective treatment for patients with adenomyosis. HIFU combined with Mirena or HIFU combined with GnRH-a and Mirena can significantly enhance the long-term treatment results.

中文翻译：

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高强度聚焦超声在子宫腺肌病的治疗中：单个中心的长期结果

摘要

客观的

目的探讨高强度聚焦超声（HIFU）治疗的子宫腺肌病患者的长期临床结局。

材料和方法

2012年6月至2020年1月，我们中心对2311例子宫腺肌病患者进行了HIFU治疗，对1982例临床资料完整的患者进行了回顾性研究。在完成随访的患者中，485例接受HIFU单独治疗，289例接受HIFU继之以GnRH-a治疗，255例接受HIFU联合Mirena治疗，594例接受HIFU联合GnRH-a和Mirena治疗。比较HIFU治疗前后3个月，6个月，1年，2年，3年和5年的痛经严重程度疼痛评分和月经过多的平均评分。记录不良反应。此外，比较了用GnRH-a和/或Mirena治疗的患者之间的疗效。

结果

HIFU消融后，在每个随访时间点痛经严重程度疼痛评分和月经过多严重程度评分均显着降低。但是，观察到随着随访时间的增加，HIFU治疗改善痛经和月经过多的有效率下降。6个月和3年的随访结果表明，HIFU联合Mirena和HIFU联合GnRH-a和Mirena的疗效显着高于单独HIFU和HIFU联合GnRH-a的疗效（p  <0.05）。主要并发症很少。

结论

HIFU对子宫腺肌病患者是一种安全有效的治疗方法。HIFU联合Mirena或HIFU联合GnRH-a和Mirena可以显着提高长期治疗效果。