经皮穿刺导管引导下泡沫硬化剂疗法治疗卵巢静脉曲张

Percutaneous puncture catheter-directed foam sclerotherapy of ovarian varicocele

目的探讨导管引导下的泡沫硬化剂疗法治疗卵巢静脉曲张的临床效果。方法选择2008~2009年就诊于我中心诊断为卵巢静脉曲张的患者共13例,平均年龄39.4(31~52)岁,病史1~20年。经皮穿刺导管引导左侧卵巢静脉主干内注射1%聚桂醇泡沫硬化剂,观察静脉主干的闭合情况。结果患者均在导管引导下成功注射硬化剂,泡沫硬化剂平均用量6.2(4~9)ml。术后平均随访时间5.3(1~12)个月,12例患者站立时盆腔坠胀不适感消失,1例减轻;5例性交痛患者中2例症状消失,3例减轻;3例大腿内侧曲张静脉较前减轻。复查超声提示未见卵巢静脉主干闭塞不满意。结论经皮穿刺导管引导的泡沫硬化剂疗法治疗卵巢静脉曲张主干闭合率较高,是微创治疗中一种有效的新方法。

Objective To investigate clinical effects of catheter-directed foam sclerotherapy for ovarian varicocele. Methods A selective series of 13 females,mean age 39.4 years, of the ovarian varicocele were treated with foam sclerotherapy using a standard technique for foam delivery from 2008 to 2009. Patients were treated with 1% polidocanol foam through a catheter, which was inserted percutaneously over a guidewire into the trunk of vena ovarica. All successfully treated patients were examined by colour duplex 1 to 12 months after the procedure. Results Thirteen patients with an insufficiency reflux of the vena ovarica were treated with the catheter-directed foam sclerotherapy. Primary technical success was achieved in all patients. The concentrations (1.0%) and doses (4~9 ml) of lauromacrogal was mainly used. Mean follow-up time was 5.3 months. Pelvic cavity flatulency was totally released in 12 patients,1 was partly released. Two of the 5 patients who had sexual pain recoverd and other 3 alleviated, 3 patients who combined with perineal region varicosis improved.During follow-up,the trunk of the vena ovarica were all occluced. Conclusion The use of percutaneously catheter directed foam sclerotherapy over a guidewire is feasible and has resulted in high primary occlusion rates.