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中文摘要：
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。
英文摘要：
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.
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