子宫动脉栓塞术治疗子宫肌瘤临床分析

Analysis of Uterine Artery Embolization for the Treatment of Uterine Leiomyomas

目的 分析子宫动脉栓塞术 (UAE)治疗子宫肌瘤的疗效及并发症。方法 选用 4F或 5FCobra导管插管至双侧子宫动脉 ,给予聚乙烯醇 (PVA)或PVA加用明胶海绵栓塞子宫动脉至血流停止。分析 1999年 10月至 2 0 0 2年 11月在本院接受UAE治疗的 10 5例子宫肌瘤患者的情况。结果 最大肌瘤体积术后 6个月和 12个月分别平均缩小 5 2 %和 5 3% ,月经过多、腹痛腹胀及尿频缓解明显 ,而月经周期缩短、经期延长改善不明显。UAE术后 5 9%的患者出现栓塞后综合征 (不同程度的下腹痛、发热、呕吐等 ) ,对症处理后缓解或消失。结论 作为一种微创手术 ,UAE可有效缩小肌瘤的体积 。

Purpose: To investigate the clinical outcome and complications of uterine artery embolization (UAE) for the treatment of uterine leiomyomas. Methods: 105 patients with uterine leiomyomas who were treated by UAE in our hospital during 1999 and 2002 were analysed retrospectively. The bilateral uterine arteries were super-selected with 4F or 5F Cobra catheter and embolized with polyvinyl alcohol (PVA) particles or PVA plus gelatin sponge until hemostasis. Results: The mean reductions in dominant fibroids of 6 months and 12 months later were 52% and 53% . The significant improvement were reported for menorrhagia, pain, urinary frequency. But the symptoms of prolonged menses and shortened menstrual cycle were not obviously improved. 59% of all patients developed symptoms such as abdominal pain, fever and nausea, which alleviated after treatment. Conclusions: As a minimal invasive surger , UAE can reduce fibroid volume and relief clinical symptoms significantly.