海藻酸钠微球介入治疗子宫肌瘤的近期临床疗效

Study on new embolismic agent KMG in uterine artery embolism for uterine myoma

目的 探讨新型栓塞剂海藻酸钠微球(KMG)应用于子宫动脉栓塞术(UAE)治疗子宫肌瘤的近期临床疗效及不良反应。方法 选择10 0例子宫肌瘤患者,以Seldinger’s技术完成单侧股动脉插管,用4～5F眼镜蛇导管(Cobra)或3F微导管超选择插管至双侧子宫动脉上行支,以携带有抗生素的5 0 0～90 0 μmKMG进行栓塞。结果 数字减影血管造影(DSA)显示子宫肌瘤血供丰富,由子宫动脉供血,部分患者卵巢动脉也参与供血。KMG应用于UAE治疗子宫肌瘤3～6个月后临床症状明显缓解,月经量减少2 5 3%～75 0 % ;UAE治疗后第3,6个月肌瘤体积分别缩小4 1 7% ,6 5 8% ,子宫体积分别缩小35 4 % ,4 4 9%。术后有不同程度的下腹痛、低热,持续1～3周不等,对症处理后消失。结论 新型栓塞剂KMG应用于UAE治疗子宫肌瘤可有效地缩小肌瘤体积,并明显改善子宫肌瘤的临床症状,是一种适用于子宫肌瘤介入治疗的安全、有效、易于操作的新型栓塞剂。

Objective To study the efficacy and side effects of sodium alginate(KMG), a new embolismic agent used in uterine artery embolism(UAE) for treating uterine myoma. Methods UAE was performed in 100 patients with uterine myoma. 4～5 F cobra catheter of 3F microcatheter was inserted into uterine arteries. KMG with a diameter of 500～900 μm mixed with antibiotics was used to embolize the arteries. Results DSA showed that blood supply of uterine myoma was rich and was mainly from uterine arteries but partly from ovarian arteries. Clinical symptoms singnificantly relieved 3～6 months after UAE using KMG as embolismic agent. Menorrhagia was reduced by 25.3%～75.0%; The volume of uterine myoma was reduced by 41.7% and 65.8% 3 and 6 months after UAE, respectively. The volume of uterus was reduced by 35.4% and 44.9%. Abdominal pain and low fever were found after UAE, which lasted for 1～3 weeks and disappeared after treatment. Conclusion New embolismic agent-KMG used in UAE can decrease the volume of myoma and relieve the clinical symptoms effectively. It is a safe, effective and easily using embolismic agent for interventional treatment of uterine myoma.