子宫腺肌病的介入栓塞治疗

Interventional embolization therapy for adenomyosis

目的探讨子宫动脉栓塞术治疗子宫腺肌病的效果及其临床应用价值。方法选择15例超声或磁共振(MR)诊断明确的子宫腺肌病患者,穿刺股动脉后使用5F子宫导管或Cobra导管超选择双侧子宫动脉,造影明确后注入直径300-700μm的海藻酸钠(KMG)颗粒或聚乙烯醇(PVA)颗粒进行栓塞。术后分别在第3,6个月来院复查,并在第6个月行超声或MR观察病灶恢复情况。结果子宫动脉栓塞治疗后,月经逐渐恢复正常,贫血症状改善,其中10例患者术后痛经消失,2例明显缓解,6个月后复查无复发;另3例患者术后3个月症状有所缓解,但第6个月复查时已复发。所有患者术后6个月复查超声或MR提示:子宫动脉栓塞后血流信号明显减少,宫体及病灶体积均有不同程度的缩小。结论介入子宫动脉栓塞术是治疗子宫腺肌病的一种便捷、微创、疗效显著的方法。

Objective To assess the value of uterine artery embolization in treatment of adenomyosis.Methods Fifteen adenomyosis patients received uterine artery angiography.Sodium polymannuronate particles（KMG）or polyvinyl alcohol particles（PVA）was used to embolize the uterine capillary bed.After follow-up for 3 and 6 months,all cases were reexamined by MR or ultrasound,respectively.Results The menorrhagia was controlled and the symptoms of anemia were released.Dysmenorrhoea disappeared or obviously released in 12 cases,and no one recurred after follow-up for 6 months.In other three cases,all symptoms above alleviated at 3 month after operation,but relapsed at 6 month.MR or sonography showed that the blood-flow signal within uterine artery decreased obviously after embolization.Conclusion Interventional uterine arterial embolization is an effective and less invasive way to treat adenomyosis.