动脉栓塞治疗子宫肌瘤的临床研究

Clinical Research on Arterial Embolism on Treating Endometrioma

目的研究介入性动脉栓塞治疗子宫肌瘤的临床价值。方法采用Seldinger技术,行双侧髂内—子宫动脉造影,了解子宫肌瘤的供血情况,用微导管超选择插入子宫肌瘤供血动脉远端,行动脉栓塞。结果30例患者子宫动脉均由同侧髂内动脉发出。子宫肌瘤由双侧子宫动脉供血,并均显示丰富。呈双侧优势型18例,占60%;双侧子宫动脉参与供血,但一侧供血较明显,供血量超过对侧的1/2者10例,占33%;仅有一侧供血者2例,占6.6%。栓塞后患者原有的临床症状消失。3个月超声复查,肌瘤平均缩小40%,6个月复查平均缩小60%,12个月复查平均缩小65%,临床总有效率100%。结论子宫肌瘤动脉栓塞是一种安全、微创的可行方法,值得推广。

Objective To explore the clinical effects on arterial embolism on endometrioma. Methods Bilateral internaliliac - uterine artery contrast examinations were made with Seldinger technique to explore the blood supply of endometrioma. Arterial embolism was performed by inserting microcatheter into the distal part of the artery which provided blood for endometrioma. Results All of the uteri arteries in 30 cases of endometrioma extended from the homolateral internaliliac arteries. Bilateral uterine arteries provided enough blood for endometrioma. 18 cases （60 96 ） showed advantages in bilateral blood supply. 10 cases （33 96 ） showed that one of the bilateral arteries could provide more blood than the other. Only 2 cases （6.6 96 ） had unilateral blood supply. Clinical symptoms disappeared in all cases after embolism. The 3 - month,6 - month and 12 - month reexaminations indicated that the endometrioma shrank by 40 96,60 96 and 65 % respectively. The total clinical efficacy was 100 %. Conclusion Arterial embolism can produce good curative effects and deserves to be widely spread clinically for its safety, microtrauma and feasibility.