|
|
|
| Efficacy of gonadotropin-releasing hormone agonist combined with the contrast-enhanced ultrasound-guided percutaneous radiofrequency ablation for treating adenomyosis |
| General Hospital of Huainan Oriental Hospital Group, Huainan, Anhui Province, 232001 |
|
|
|
|
Abstract To observe the efficacy of gonadotropin-releasing hormone agonist (GnRH-a) combined with contrast-enhanced ultrasound (CEUS)-guided percutaneous radiofrequency ablation (PFA) for treating adenomyosis (AM). Methods: From June 2019 to December 2022, 148 patients with AM were selected and were randomly divided into two groups. 74 cases in the control group were treated with CEUS-guided PFA alone, and 74 cases in the observation group were treated with CEUS-guided PFA combined with GnRH-a. The clinical efficacy, the score of dysmenorrhea by numerical rating scale (NRS), and the score by pictorial blood loss assessment chart (PBAC) before treatment and 3 months after treatment of the patients were compared between the two groups. The lesion volume and uterine volume of the patients in the two groups were measured. The levels of serum sex hormone, cancer antigen 125 (CA125), vascular endothelial growth factor (VEGF), and hemoglobin (Hb) of the patients in the two groups were detected. Results: The effective rates of the patients in observation group in 3 months (100%) and 6 months (92.5%) after treatment were significantly higher than those (83.8% and 66.2%) of the patients in the control group, and the recurrence rate (4.1%) of the patients in the observation group was significantly lower than that (12.2%) of the patients in the control group. After 3 months of treatment, the NRS and PBAC scores of the patients in both groups had decreased significantly, the lesion volume and the uterine volume of the patients in both groups had decreased significantly, and the change degrees of which of the patients in the observation group were significantly more than those of the patients in the control group. The levels of serum estradiol (E2), luteinizing hormone (LH), and follicle stimulating hormone (FSH) of the patients in the observation group were significantly lower than those of the patients in the control group. The decreasing amplitude of the CA125 and VEGF levels and the increasing amplitude of the Hb level of the patients in the observation group were significantly better than those of the patients in the control group (P<0.05). There was no significant difference in the adverse reaction rate (4.1% vs. 0) of the patients between the two groups (P＞0.05). Conclusion: CEUS-guided PFA combined with GnRH-a for treating the patients with AM can improve their clinical efficacy, and which can regulate the sexual hormone levels, can reduce the levels of CA125 and VEGF, can effectively relieve the dysmenorrhea and improve the menstrual disorders, and can reduce the recurrence rate of AM of the patients, without increasing the adverse reaction.
|
|
|
|
|
|
|
|
|
