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经阴道子宫肌层及内膜微波消融治疗伴贫血的子宫腺肌病的临床疗效。

Clinical efficacy of myometrial and endometrial microwave ablation in the treatment of patients with adenomyosis who had anemia.

机构信息

Department of Ultrasound, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China.

Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

Int J Hyperthermia. 2022;39(1):1335-1343. doi: 10.1080/02656736.2022.2131001.

Abstract

OBJECTIVE

This study evaluated the clinical efficacy of myometrial and endometrial microwave ablation (MEWA) for treating adenomyosis in patients with anemia.

METHODS

This retrospective study enrolled 64 patients with adenomyosis who had anemia treated with either MEWA (MEWA group) or myometrial microwave ablation (MMWA group) between May 2019 and May 2021. The uterine volumes, uterine-volume reduction rates, hemoglobin (Hb) levels, cancer antigen 125 (CA125) levels, dysmenorrhea visual analog scale (VAS) scores, uterine fibroblast symptoms and health-related quality of life (UFS-QOL) scores, menstrual flow scores (MFS) before and 3, 6, and 12 months post-treatment, and adverse events and complications in both groups were collected to assess clinical efficacy.

RESULTS

No statistically significant preoperative differences were observed in any measured factors. Postoperatively, there was a significant reduction in uterine volume and CA125 level, an increase in Hb level, and improvement in the UFS-QOL, dysmenorrhea VAS score, and MFS. No differences were observed in postoperative uterine volume, CA125 level, overall response rate, and adverse event rate during the follow-up period until 12 months postoperatively. However, the MEWA group showed a better uterine-volume reduction rate 6 months postoperatively and improvement in Hb level, USF-QOL score, dysmenorrhea VAS score, and MFS postoperatively.

CONCLUSION

MEWA and MMWA demonstrated high clinical efficacy in treating adenomyosis and anemia. However, MEWA is a more effective therapy that successfully improves anemia, resulting in improved quality of life.

摘要

目的

本研究评估了子宫内膜和肌层微波消融(MEWA)治疗贫血型子宫腺肌病的临床疗效。

方法

本回顾性研究纳入了 2019 年 5 月至 2021 年 5 月期间接受 MEWA(MEWA 组)或肌层微波消融(MMWA 组)治疗的 64 例贫血型子宫腺肌病患者。收集两组患者的子宫体积、子宫体积缩小率、血红蛋白(Hb)水平、癌抗原 125(CA125)水平、痛经视觉模拟量表(VAS)评分、子宫平滑肌症状和健康相关生活质量(UFS-QOL)评分、治疗前后 3、6 和 12 个月的月经流量评分(MFS),以及两组患者的不良反应和并发症,以评估临床疗效。

结果

术前两组患者的各项测量指标均无统计学差异。术后,子宫体积和 CA125 水平显著降低,Hb 水平升高,UFS-QOL、痛经 VAS 评分和 MFS 均得到改善。术后 12 个月内,两组患者的子宫体积、CA125 水平、总有效率和不良反应发生率无差异。但 MEWA 组术后 6 个月子宫体积缩小率和 Hb 水平、UFS-QOL 评分、痛经 VAS 评分和 MFS 改善情况更好。

结论

MEWA 和 MMWA 治疗子宫腺肌病和贫血均具有较高的临床疗效。但 MEWA 是一种更有效的治疗方法,能成功改善贫血,提高生活质量。

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