a Department of Gynecology, Shanghai First Maternity and Infant Hospital , Tongji University School of Medicine , Shanghai , PR China.
Int J Hyperthermia. 2019;36(1):486-492. doi: 10.1080/02656736.2019.1595179. Epub 2019 Apr 17.
To evaluate the combined efficacy of high-intensity focused ultrasound (HIFU), gonadotropin-releasing hormone agonist (GnRH-a) and the levonorgestrel-releasing intrauterine system (LNG-IUS) for the treatment of severe adenomyosis.
Four hundred and sixty-six patients with adenomyosis admitted to the Department of Gynecology of Shanghai First Maternity and Infant Hospital underwent HIFU treatment, and then were consecutively administered with GnRH-a 1 d, 1 month and 3 months after HIFU treatment. The uterine size was then measured with ultrasound or MRI 2-4 weeks after three cycles of GnRH-a injection. The LNG-IUS was then inserted when the uterine length less than 9 cm. The visual analog scale (VAS), verbal rating scale (VRS), menstrual volume score, uterus volume, MRI, serum levels of hemoglobin and CA125 were measured at pre and 3-, 6-, 12-month post-HIFU.
Dysmenorrhea and menorrhagia significantly relieved after combined treatment with HIFU, GnRH-a and the LNS-IUS. The uterine volume shrank and returned to its normal size. The serum CA-125 level was reduced to the normal level after the combined treatment.
The combined therapeutic regimen of HIFU, GnRH-a and LNS-IUS is safe, effective and efficient for curing severe adenomyosis.
评估高强度聚焦超声（HIFU）、促性腺激素释放激素激动剂（GnRH-a）和左炔诺孕酮宫内缓释系统（LNG-IUS）联合治疗严重子宫腺肌病的疗效。
上海第一妇婴保健院妇科收治的 466 例子宫腺肌病患者行 HIFU 治疗，HIFU 治疗后 1d、1 个月和 3 个月分别连续给予 GnRH-a 治疗，GnRH-a 注射 3 个周期后 2-4 周行超声或 MRI 测量子宫大小。当子宫长度小于 9cm 时，插入 LNG-IUS。在 HIFU 前、治疗后 3、6、12 个月，采用视觉模拟评分（VAS）、语言评定量表（VRS）、月经量评分、子宫体积、MRI、血清血红蛋白和 CA125 水平评估痛经和月经过多。
HIFU、GnRH-a 和 LNS-IUS 联合治疗后痛经和月经过多明显缓解，子宫体积缩小并恢复正常大小，血清 CA-125 水平降至正常。
HIFU、GnRH-a 和 LNG-IUS 的联合治疗方案安全、有效、高效，可治疗严重子宫腺肌病。
