CAJ | 학술논문

目的：探讨高强度聚焦超声（HIFU）联合左炔诺孕酮宫内缓释系统（LNG-IUS）治疗子宫腺肌病的临床疗效及安全性。方法选择2014年3~7月在重庆市涪陵中心医院确诊为子宫腺肌病患者40例，随机分为HIFU组和HIFU联合LNG-IUS组，各20例。治疗前和治疗后2、3、6个月进行视觉模拟评分（VAS），并检测血浆P物质水平；测量治疗后3、6个月子宫体积。结果两组患者治疗后2、3、6个月VAS及血浆P物质水平较治疗前显著降低，HIFU联合LNG-IUS组降低程度优于HIFU组，差异均有统计学意义（P<0.05）。治疗后3、6个月，两组患者子宫体积较治疗前显著缩小，差异均有统计学意义（P<0.05）；但两组治疗后子宫体积比较，差异无统计学意义（P>0.05）。所有患者在整个HIFU治疗及放置LNG-IUS过程中无严重不良反应发生。结论 HIFU联合LNG-IUS治疗子宫腺肌病较单纯HIFU疗效显著，是一种安全、有效的方法。
목적：탐토고강도취초초성（HIFU）연합좌결낙잉동궁내완석계통（LNG-IUS）치료자궁선기병적림상료효급안전성。방법선택2014년3~7월재중경시부릉중심의원학진위자궁선기병환자40례，수궤분위HIFU조화HIFU연합LNG-IUS조，각20례。치료전화치료후2、3、6개월진행시각모의평분（VAS），병검측혈장P물질수평；측량치료후3、6개월자궁체적。결과량조환자치료후2、3、6개월VAS급혈장P물질수평교치료전현저강저，HIFU연합LNG-IUS조강저정도우우HIFU조，차이균유통계학의의（P<0.05）。치료후3、6개월，량조환자자궁체적교치료전현저축소，차이균유통계학의의（P<0.05）；단량조치료후자궁체적비교，차이무통계학의의（P>0.05）。소유환자재정개HIFU치료급방치LNG-IUS과정중무엄중불량반응발생。결론 HIFU연합LNG-IUS치료자궁선기병교단순HIFU료효현저，시일충안전、유효적방법。
Objective To investigate the clinical curative effect and safety of high intensity focused ultrasound (HIFU) for treating adenomyosis combined with levonorgestrel-releasing intrauterine system(LNG-IUS). Methods 40 patients diagnosed as adenomyosis in Chongqing Fuling Central Hospital from March 2014 to July 2014 were selected and randomly divided into the HIFU group(n=20) and HIFU combined LNG-IUS group(n=20). The visual analogue scale(VAS) was conducted before and af-ter 2,3,6 months of treatment and plasma levels of substance P was detected . The uterus size after 3 ,6 months of treatment was measured. Results The VAS score and plasma levels of substance P of both groups were remarkably reduced after 2 ,3,6 months of treatment. However,the VAS score and plasma levels of substance P of the HIFU combined LNG-IUS group were reduced more than those of the HIFU group,differences showing statistical significance(P<0.05). The uterus sizes of both groups shrank notably after 3,6 months of treatment,differences showing statistical significance(P<0.05). The uterus sizes after treatment had no statis-tical differences between the two groups(P>0.05). All the patients had no severe adverse reactions during entire HIFU treatment and LNG-IUS placing process. Conclusion HIFU combined with LNG-IUS has significant effect for treating adenomyosis and is a safe and effective method.