选择性子宫动脉栓塞术治疗子宫肌瘤两种栓塞方法的对照研究

A comparative study of two methods for treatment in uterine fibroids with selective uterine artery embolization

目的:对照研究子宫动脉栓塞术治疗子宫肌瘤中两种栓塞剂的中短期疗效.方法:36例患者,临床症状均为月经量过多,不同程度贫血、盆区疼痛,术前检查明确诊断为子宫肌瘤,根据栓塞剂的不同随机分为2组,Ⅰ组22例采用平阳霉素-碘油乳剂+真丝线段,Ⅱ组14例采用PVA+真丝线段,两组中肿瘤直径均大于5 cm×5 cm,所有患者均为1次栓塞.结果:插管成功率98.6%,随诊3～6个月,B超显示两组肿瘤平均体积分别缩小了57%、64%和54%、65%,其中1例肿瘤消失,所有患者术后贫血症状改善,月经恢复正常,无严重并发症,两组间未见显著差异.结论:两种栓塞剂治疗子宫肌瘤在技术成功率、肿瘤缩小率和临床有效率等方面无显著差异(P＞0.05),但Ⅱ组术后缺血性疼痛更明显,PLE值得推广.

Objective:To Compare and assess the clinical effects of two artery embolization methods for treatment in uterine fibroids with selective uterine artery embolization.Methods:36 cases were randonly devided into two groups with different embolization.Ⅰgroup :22 cases were treated with PYM and Lipido-Morrhuate Sodium and the silk fragment , Ⅱ group: 14 cases were performed with PVA and the silk fragment. All patients with refractory vaginal bleeding, pelvic pain , different lever anemia . UF were clear-cut diagnosed before the treatment only once . All the diameter of myomas more than 5×5 cms .Results:98.6% patients underwent technically successful embolization.B-made ultrasound examination follwing 3~6 months after the procedure revealed an average shrinkage of 57~64% in volume of the masses for Ⅰ group and 45~65% for Ⅱ group , with 1 UF disappeared,menorrhagia controlled and anemia resolved . No serious complications related to the procedure have occurred . There was no statistical difference between the measurements of the two groups.Conclusion:There is no statistical difference between the successful rate of catheterization , average shrinkage and the clinical effects in two kinds embolization .But ache occluding blood supply is very apparent in Ⅱ group , and the PLE deserve the expansion .