不同栓塞剂栓塞子宫肌瘤的疗效对比

Comparison of different embolism agents in the treatment of uterine leiomyoma

目的探讨不同栓塞剂行子宫动脉栓塞治疗子宫肌瘤的疗效、术后副反应及并发症。方法107例子宫肌瘤行子宫动脉栓塞,其中41例用聚乙烯醇栓塞(PVA组),66例用平阳霉素碘油乳剂和真丝线段栓塞(PLES组)。随访6个月,观察临床症状改变、肌瘤大小变化、术后副反应及并发症。结果PVA、PLES组贫血改善率分别为938%(15/16)、905%(19/21)(χ2=0000,P=1000);2组月经量减少、经期基本恢复正常,改善率分别为947%(18/19)、923%(24/26)(χ2=0000,P=1000),压迫症状消失率分别为600%(6/10)、533%(8/15)(χ2=0000,P=1000),腹痛症状消失率分别为889%(8/9)、813%(13/16)(χ2=0000,P=1000)。2组疗效及症状改善率差异无显著性(P>005)。PVA组栓塞后发热发生率220%(9/41)明显低于PLES组848%(56/66)(χ2=41958,P=0000),2组栓塞术后恶心、呕吐和腹部疼痛发生率差异无显著性(P>005)。2组均无异位栓塞及严重的并发症。结论PVA与PLES行子宫动脉栓塞治疗子宫肌瘤疗效显著、相同,2种栓塞剂术后副反应发生无差别。

Objective To explore the effectiveness, side effects and complications of uterine artery embolization (UAE) for uterine leiomyoma using different embolism agents. Methods A total of 107 patients underwent UAE by using either polyvinyl alcohol (Group PVA, 41 patients) or pingyangmycin lipiodol emulsion silk-segment (Group PLES, 66 patients). After 6 months of follow-up, clinical symptoms, tumor volumes, postoperative side effects and complications were observed, respectively. Results The amelioration rate of anemia was 93 8% (15/16) in the Group PVA and 90 5% (19/21) in the Group PLES, respectively ( χ 2 =0 000, P =1 000). The flow of the menstrual cycle decreased and regular menstruation recovered in the two groups, with the amelioration rate of 94 7% (18/19) in the Group PVA and 92 3% (24/26) in the Group PLES, respectively ( χ 2 =0 000, P =1 000). The disappearance rate of compression symptoms was 60 0% (6/10) and 53 3% (8/15), respectively ( χ 2 =0 000, P =1 000), and of abdominal pain was 88 9% (8/9) and 81 3% (13/16), respectively ( χ 2 =0 000, P =1 000). There was no significant variation in effectiveness and amelioration rate between the two groups ( P >0 05). The incidence of fever after embolization in the Group PVA was 22 0% (9/41), which was significantly lower than that of 84 8% (56/66) in the Group PLES ( χ 2 =41 958, P =0 000). There was no significant difference in the incidence of postoperative nausea, vomiting and abdominal pain between the two groups ( P >0 05). No other embolisms or severe complications occurred in the two groups. Conclusions No substantive differences were detected between outcomes of embolization with PVA and PLES.