经导管子宫动脉栓塞术治疗子宫肌瘤的临床应用研究

Clinical application of transcatheter uterine artery embolization for treatment of Uterine fibroids

目的探讨经导管子宫动脉栓塞术治疗子宫肌瘤的方法、疗效及并发症。方法本组94例，由临床、超声、CT检查确诊为子宫肌瘤，其中黏膜下肌瘤9例，肌壁间肌瘤74例，浆膜下肌瘤11例；单发肌瘤25例，多发肌瘤69例。采用Seldinger技术，经导管双侧子宫动脉注入超液化碘油-平阳霉素乳剂，然后以明胶海绵颗粒栓塞子宫动脉近端。栓塞后3个月、6个月回院复查。结果插管成功率100％。随访3～6个月，所有病例在治疗后3个月B超示肌瘤体积平均缩小51％，瘤体内血流信号明显减少；6个月肌瘤体积平均缩小43％，其中23例肌瘤消失。所有病例月经恢复正常；贫血病例，血红蛋白升至正常范围。并发症发生率6．3％（6／94），经处理后均恢复正常。结论TUAE治疗子宫肌瘤创伤小，疗效显著；TUAE并发症少，是可以防治的。

Objective To study the methods and effect and complications of transcatheter uterine artery embolization （TUAE） for uterine fibroids. Methods The diagnosis of 94 patients was assumed by clinical, color Doppler ultrasound and CT imaging. Among them, 9 fibroids were located under mucous membran, 74 in the myometrium, 11 under serous membrane. 25 single fibroid, 69 multiple fibroid. Seldinger technique was used, bilateral uterine arteries were embolized using lipiodol-pingyangmycin emulsion （LPE）, together with Gelfoam particles. Results The successful rate of catheterization almost reached 100%. All patients were followed up for 3 to 6 months. B-mode ultrasound examination following 3～12 months after the procedure re veiled an average shrinkage of 51% in volume of the masses for all cases in the first 3 months and 43% in volume in 6 months, with 23 uterine fibroids disappeared. Menses returned to regular cycle. In the patients with anemia, the hemoglobin concentration rose up to normal level. The complication rate is 6.3 % （6/94）, all the side effects of TUAE recovered to normal after special treatment. Conclusion TUAE is an effective and less invasive way to treat uterine fibroids, the complications of TUAE are preventable and curable.