子宫动脉栓塞治疗子宫腺肌病对卵巢功能的影响

Effect of uterine artery embolization used in treatment of adenomyosis on ovarian funtion

目的:探讨子宫动脉栓塞治疗子宫腺肌病对卵巢功能的影响。方法:对27例子宫腺肌病患者采用聚乙烯醇微粒(PVA)进行子宫动脉栓塞治疗,在栓塞前、栓塞后3个月及6个月,评估所有病人的症状改善情况,并且采用经阴道彩色能量多普勒超声对子宫及病灶进行动态监测,监测子宫大小,子宫动脉和卵巢动脉血流动态改变,及基础性激素水平和基础体温情况。结果:子宫动脉栓塞术后3个月,子宫体积显著减小,平均缩小136.48(37.6%),子宫动脉的最大血流速度Vmax(cm/s)显著降低,由(27.27±6.03)cm/s降至(14.19±5.98)cm/s,P<0.05。子宫动脉阻力指数(RI)由0.54±0.03降至0.86±0.04,P<0.05;栓塞术前、后卵巢血流、卵泡刺激素(FSH)、雌二醇(E2)和月经周期无显著性差别。1例患者出现短暂卵巢功能急剧减退。结论:子宫动脉栓塞治疗子宫腺肌病是一种新颖、微创、安全、有效、并发症少且恢复快的治疗方法,可保留子宫的生育功能,对卵巢功能无明显损害,但应注意可能导致卵巢衰竭。

Objective： To investigate the effects on ovarian function of uterine artery embolization （UAE） for the treatment of adenomyosis and complications of UAE. Methods： UAE was performed in 27 cases with adenomyosis, and the embolic agent was polyvinyl alcohol particles （PVA） . The effects of the treatment, levels of sexual hormone were evaluated, and the uterus artery and ovarian artery were examined with transvaginal Color Doppler Energy Sonography （TVCDES） before UAE and the 1st day, 3 months, 6 months after UAE. Results： After 3 months of UAE, the volume of uterus was decreased dramatically by 136. 48 cm^3 （37. 6% ）, Vmax （cm/s） of uterine artery was lower, from （27.27±6.03） cm/s to （ 14. 19 ±5.98） cm/s, P 〈0. 05, RI of uterine artery was increased, form 0. 54 ±0. 03 to 0. 86 ±0. 04, P 〈0. 05; There was no difference in ovarian blood stream, FSH, E： and menstrual cycle after UAE; One patient had short phase of ovarian function reduction dramatically. Conclusion： UAE for adenomyosis is a new, less - trauma, safe, effective, less -complications and short- time recovery therapy with satisfying midterm effects, which can preserve uterine function and do not damage the function of ovaries, but it may cause ovarian failure.