弥漫型与局灶型子宫腺肌病动脉栓塞术后疗效观察

Observation of therapeutic effect on uterine arterial embolization in diffuse and local adenomyosis

目的:探讨子宫动脉栓塞术(Uterine arterial embolism UAE)对弥漫型子宫腺肌病(adenomyosisAM)和局灶型子宫腺肌病是否具有相同的临床疗效。方法:选择56例AM患者进行UAE治疗,其中局灶型16例、弥漫型40例.观察两组患者UAE前及UAE后3、6、12、24、48个月月经量、痛经程度评分、子宫体积、血清CA125的变化及两组的副作用情况。结果:56例患者全部栓塞成功,根据临床症状,两组有效率分别达83.3%(10/12)、81.3%(26/32)。其中两组患者月经量、痛经程度评分于UAE后3个月开始下降(P<0.05),于UAE后6个月下降最显著(P<0.01)。血清CA125下降和子宫体积缩小相一致,术后12个月达最低点(P<0.01);两组组间比较差异无显著性(P>0.05)。所有病例随访48个月,无一例复发。结论:子宫动脉栓塞治疗弥漫型和局灶型子宫腺肌病的效果显著,疗效相似。

Objective：To investigate whether uterine arterial embolization （UAE） has the same effect on local and diffuse adenomyosis. Methods： Total 56 patients were enrolled and treated with UAE in 16 cases with local adenomyosis, the others with diffuse adenomyosis. The degree of dysmenorrhea, amount of menorrhea, uterine volume changes of the level of serum CA125 and side effects were investigated before and after 3, 6, 12, 24 and 48 months when UAE was used. Results： All 56 cases were embolized successfully. The clinical effects on local and diffuse adenomyosis were 83.3% （10/12） and 81.3% （26/32）, respectively. The amount of menorrhea, the degree of dysmenorrhea, the uterine volume, level of serum CA125 all decreased or declined significantly afer UAE 3 months （P〈0.05）. Compared with other follow-up time,the degree of dysmenorrhea and the amount of menorrhea declined to their lowest points in the 6th months after UAE （P〈0.01）. Parelleled to the decreased of volume of uterin, serum CA125 also decreased significantly and down to the least in the 12 th month （P〈0.01）. No recurrences were found during 48 months after UAE. Conclusions： UAE has a remarkable and similar effect on diffuse and local adenomyosis.