子宫动脉栓塞术治疗子宫肌瘤近远期疗效观察

Recent and prospective efficacy of uterine arterial embolization on uterus myoma

目的:分析子宫动脉栓塞术治疗子宫肌瘤的近期疗效以及术后患者远期妊娠情况.方法:选择在我院治疗的53例子宫肌瘤患者,单侧股动脉插管,根据DSA检查结果,选用管径为4-5F的脾管、肝管或者Cobra管,插管至双侧子宫动脉并经DAS检查确认后,以明胶海绵颗粒实施栓塞术.结果:实施子宫动脉栓塞术后,观察并随访6～48mo,肌瘤在实施栓塞术后体积明显缩小,均值由术前(155±13)cm3下降到术后的(51±9)cm3,差异有统计学意义(P<0.05).肌瘤患者临床症状明显缓解,压迫症状消失.月经量、月经周期和经期改变差异有统计学意义(P<0.05).术后性激素均值与治疗前比较无统计学意义差异(P>0.05).53例患者,避孕7例,其余46例35次妊娠均为自然受孕,妊娠率76.1%.结论:子宫动脉栓塞术可以有效地缩小子宫肌瘤的体积,改善临床症状,且患者在治疗后可以正常地受孕和分娩.

AIM： To explore the recent and prospective efficacy of uterine arterial embolization （UAE） on uterus myoma and the patient＇s pregnancy status after the operation. METHODS： UAE was performed in 53 patients with uterine myoma. The 4-5 F cobra catheters were inserted into the uterine arteries for treatment. Gelfcam particles were used to embolized the arteries. RESULTS： The follow-up time lasted for 6-48 too. The volume of uterus myoma decreased from （ 155 ± 13） cm^3 to （51 ±9） cm^3 （P 〈 0. 05 ）. All the clinical symptoms of the patients were relieved. The menstrual blood volume, menstrual cycle, and the duration of menstruation changed significantly after operation（ P 〈 0.05）. No obvious changes of sex hormones were observed （ P 〉 0.05）. Among the 46 patients of the post-operation, 35 cases were successfully conceived, with the rate of pregnancy of 76.1%. CONCLUSION： The UAE can reduce the volume of the uterus myoma significantly and relieve the clinical symptoms. The patients can conceive successfully after the operation.