不同栓塞剂经子宫动脉栓塞治疗子宫肌瘤术后疼痛程度的对比

Comparison of Pain After Uterine Artery Embolization using Different Embolic Agents in Treatment for Symptomatic Fibroids

目的对比不同栓塞剂经子宫动脉栓塞治疗子宫肌瘤术后的疼痛程度。方法回顾性分析66例行子宫动脉栓塞(UAE)的子宫肌瘤患者,根据不同栓塞剂将碘化油、聚乙烯醇(PVA)、微球分为3组。患者术后携带自控式镇痛泵(PCA)镇痛。术后1、6、12、24 h根据数值评分量表(NRS)测得患者疼痛程度。对比分析3组患者术后NRS值、PCA泵入镇痛药物剂量及术后6个月肌瘤直径情况。结果术后1~6 h,A组患者疼痛感大于B、C两组,差异有统计学意义(P<0.05)。术后24~48 h,C组患者疼痛感大于A、B两组,差异有统计学意义(P<0.05)。术后随访6个月,B、C组最大肌瘤直径<A组,差异有统计学意义(P<0.05),而B、C两组间差异无统计学意义(P>0.05)。结论PVA在UAE术后导致的疼痛程度较碘化油与微球低,且临床疗效优于碘化油,是UAE较为理想的栓塞剂。

Objective To evaluate the post-procedural pain and efficacy associated with uterine artery embolization(UAE)using different embolic agents in treatment for symptomatic fibroids.Methods 66 UAE patients with fibroids were consecutively enrolled in this retrospective study.Cases were grouped according to type of embolic agents.All patients were admitted with PCA pump postoperatively.Pain was assessed during admission,using a numerical rating scale(NRS)after treatment.Both anesthetic dose after 48 hr and a fibroid tumor-diameter after 6 month were also compared between the three groups.Results The patients in group A experienced significantly more pain than other groups during the first 6 hrs after treatment,This difference was significant(P<0.05).The patients in group C experienced significantly more pain than other groups during the 24-48 hr after treatment and the difference was also significant(P<0.05).Among the clinical outcome measures,the maximum tumor diameter of a mean reduction in group B and C was larger than group A.This difference was significant(P<0.05),but the difference was not significant between group B andC group C(P>0.05).Conclusion The pain caused by PVA after UAE is lower than lipiodol and microspheres,and It is the ideal embolic agent for UAE.