Abstract:

Objective　To study the difference in the postoperative dysmenorrhea relief degrees of high intensity focused ultrasound (HIFU) and uterine artery embolization (UAE) in the treatment of patients with adenomyosis. Methods　A retrospective analysis was conducted on the patients with adenomyosis and dysmenorrhea with complete clinical data who received HIFU treatment [40 cases, aged (38.10±3.23) years] or UAE treatment [36 cases, aged (38.22±3.30) years] from Liwan Central Hospital of Guangzhou from January 2018 to June 2021. All the patients were diagnosed as adenomyosis by MRI, and their dysmenorrhea degree was evaluated by the Visual Analogue Scale (VAS). The degrees of dysmenorrhea relief 1, 3, 6, and 12 months after surgery was observed. t test and χ² test were used. Results　The follow-up time of the HIFU treatment group [(15.3±1.3) months] and the UAE treatment group [(15.1±0.9) months] showed no statistically significant difference (t=1.325, P=0.134). There was no statistically significant difference in the VAS score between the two groups before surgery and 1, 3, and 12 months after surgery (all P>0.05). The VAS score of the UAE treatment group [(3.19±0.19) points] was lower than that of the HIFU treatment group [(3.68±0.14) points] 6 months after surgery, with a statistically significant difference (t=2.746, P=0.006). Conclusion　For patients with adenomyosis and dysmenorrhea, the short-term (6 months after treatment) efficacy of dysmenorrhea relief after UAE treatment is better than that of HIFU treatment.

Key words:

Adenomyosis, Dysmenorrhea, Uterine artery embolization, High intensity focused ultrasound

摘要：

目的　对比研究高强度聚焦超声（high intensity focused ultrasound，HIFU）和子宫动脉栓塞术（uterine artery embolization，UAE）治疗子宫腺肌病患者术后痛经缓解程度的差异。方法　对广州市荔湾中心医院2018年1月至2021年6月选择HIFU治疗［40例，年龄（38.10±3.23）］或UAE治疗［36例，年龄（38.22±3.30）岁］的资料完整有痛经症状的子宫腺肌病患者进行回顾性分析。所有患者经MRI检查诊断为子宫腺肌病，并使用视觉模拟评分法（Visual Analogue Scale，VAS）评价痛经程度。观察患者术后1、3、6、12个月痛经缓解程度。采用t检验、χ²检验。结果　HIFU治疗组随访时间［（15.3±1.3）个月］与UAE治疗组［（15.1±0.9）个月］比较，差异无统计学意义（t=1.325，P=0.134）。术前及术后1、3、12个月，两组患者痛经VAS评分比较，差异均无统计学意义（均P>0.05）；术后6个月，UAE治疗组的痛经VAS评分［（3.19±0.19）分］低于HIFU治疗组［（3.68±0.14）分］，差异有统计学意义（t=2.746，P=0.006）。结论　对于有痛经症状的子宫腺肌病患者，选择UAE治疗后的近期（术后6个月）痛经缓解程度优于选择HIFU治疗。

关键词:

子宫腺肌病, 痛经, 子宫动脉栓塞, 高强度聚焦超声