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目的:将高强度聚焦超声(HIFU)消融联合左炔诺孕酮宫内缓释系统用于子宫腺肌病患者的治疗，并探讨其临床价值。方法:选取2015年1月至2018年1月本院妇产科诊治的子宫腺肌病患者作为研究对象，根据患者意愿及治疗方法，将入组病例分为两组：联合治疗组采用HIFU联合左炔诺孕酮宫内缓释系统(LNG-IUS)治疗，单纯HIFU组仅采用HIFU治疗；分别比较两组治疗前后病灶体积和子宫体积缩小率、血红蛋白、CA125和主诉疼痛分级法(VRS)评分，记录治疗后不良反应发生情况。结果:两组病例治疗后随访12个月：联合治疗组病灶体积缩小率和子宫体积缩小率均优于单纯HIFU组[(58.8±14.1)% vs (49.3±17.2)%，(37.4±6.2)% vs (32.9±5.0)%，n P<0.05]，血红蛋白水平高于单纯HIFU组[(113.4±12.8)g/L vs (107.5±10.6)g/L，n P<0.05]，痛经VRS评分亦好于单纯HIFU组，差异有统计学意义(n P0.05)。n 结论:与单独采用HIFU消融比较，HIFU联合LNG-IUS治疗后子宫肌腺病患者获得更好的病灶体积缩小率和子宫体积缩小率，同时血红蛋白水平和痛经症状改善更佳。“,”Objective:To investigate the clinical value of high intensity focused ultrasound (HIFU) ablation combined with levonorgestrel releasing in uterine system (LNG-IUS) in the treatment of adenomyosis.Methods:From January 2015 to January 2018, patients with adenomyosis diagnosed and treated in Obstetrics and Gynecology of our hospital were selected as the research objects. According to the wishes and treatment methods of the patients, the patients were divided into two groups: the combined treatment group was treated with HIFU combined with LNG-IUS, and the HIFU group was only treated with HIFU; the lesion volume and uterine volume reduction rate, hemoglobin, carbohydrate antigen 125 (CA125) and verbal rating scale (VRS) scores were compared between the two groups before and after treatment, and adverse reactions after treatment the scores were recorded.Results:Cases were followed up for 12 months after treatment: the lesion volume reduction rate and uterine volume reduction rate in the combined treatment group were better than those in the HIFU group [(58.8±14.1)% vs (49.3±17.2)%, (37.4±6.2)% vs (32.9±5.0)%, n P<0.05]; the hemoglobin level was higher than that in the control group [(113.4±12.8)g/L vs (107.5±10.6)g/L,n P<0.05]. In addition, the VRS score of dysmenorrhea in the combined treatment group was also better than that in the HIFU group, with statistically significant difference (n P<0.05).n Conclusions:Compared with HIFU ablation alone, patients performed in HIFU combined with LNG-IUS achieved better lesion volume reduction rate and uterine volume reduction rate, and hemoglobin level and dysmenorrhea symptoms improved better in patients with adenomyosis.