经导管栓塞子宫动脉治疗子宫肌瘤(附8例报告)

Transcatheter uterine artery embol ization for treating uterine myoma (Report of 8casess)

目的评价经导管栓塞子宫动脉治疗子宫肌瘤的疗效。方法8例肌壁间子宫肌瘤,经右股动脉穿刺,运用seldinger技术,将4-5Fcobra导管送至双侧髂内动脉行造影,观察子宫动脉肌瘤供血染色情况。确认子宫动脉后,将导管超选至子宫动脉内,行明胶海绵颗粒栓塞,阻断肌瘤血供。结果8例肌壁间子宫肌瘤,7例双侧子宫动脉供血,1例单侧子宫动脉供血,经100%明胶海绵颗粒栓塞后造影复查,瘤体血供完全阻断,染色消失。8例术后3-4个月月经正常。术后1个月“B超”复查,证实肌瘤似较前缩小。术后3个月“B超”复查,3例肌瘤消失,术后半年“B超”复查,只有一例未完全消失,进一步证实为子宫腺肌症。术后8个月“B超”复查,腺肌症病变仍存在,但范围明显缩小,子宫大小趋于正常,临床症状完全消失。结论经导管栓塞子宫动脉是一种创伤小,治疗效果肯定的新型治疗方法。

Objective To assess the clinical effects of tra nscatheter embolization of uterine arteries in the treatment of uterine my-oma.Methods In our study,8cases with uterine myo ma were treated.According to Seldin ger' s technology,Cobra catheter(4-5F)was inserted into bilateral uterine arteries after a percutaneous femoral arterial puncture.The uterine arteries and the blood supply of myoma were observed by arteriography in double internal iliac arteries.After iden tifing the uterine arteries,We sele ctively inserted the catheter into i t and occluded the blood supply of myoma by gelform for embolizing.Results Arteriograply showed blood supply o f myoma in 8cases with uterine myoma,of them,7cases were supplied by bilateral uterine arteries,1case by single uterine arteries.After b eing embolized with 100%gelform,the blood supply of uterine myoma were completely occluded,and arteriography appeared no myoma dye.With a mean follow -up of3months,the menorrhagia and menstr ual cycles returned to normal.It was confirmed by US -B that of 8cases with uterine myoma,all became smaller in one month.5cases c ompletely disappeared in three mont hs,1case partly disappeared in 6mon ths and remained,but,didn' t enlarge in one year.Conclusions Compared with treatment of operatio n and medicine,selective uterine artery embolization is a new method for treatment of uterine myom a with less trauma.[