子宫动脉栓塞术后卵巢功能监测

MONITORING OF ovarian FUNCTION AFTER TREATING WITH UTERINE ARTERIAL EMBOLIZATION

[目的]探讨子宫动脉栓塞术治疗妇科良性疾病引起卵巢功能障碍的原因及预防方法。[方法]对我院554例因妇科良性疾病行子宫动脉栓塞术治疗患者的临床资料进行回顾性分析,其中子宫肌瘤416例,子宫肌腺瘤138例,异位妊娠5例,产后出血2例,同时对发生卵巢功能障碍的病例进行血管解剖学﹑血管影像学及微导管的使用等问题进行探讨。[结果]554例中,发生不同程度卵巢功能障碍56例,发生率10.1%,其中闭经6例(1.1%),子宫不规则出血29例(5.2%),月经稀发27例(4.9%),56例均行双侧UAE引起卵巢功能障碍的原因,为在栓塞动脉的过程中,栓塞剂进入子宫动脉发出的卵巢支。[结论]对妇科良性疾病进行UAE治疗,有发生卵巢功能障碍的危险,解剖不清,操作不熟练,未能准确分辨血管及分支是造成子宫动脉栓塞术后卵巢功能障碍的原因。

[Objective] To explore the ovarian dysfunction caused by uterine artery embolization （UAE） for treatment of gynecological benign diseases and its preventive methods. [Methods] The clinical data of 554 patients with gynecological benign diseases treated by UAE in our hospital were analyzed by retrospective analysis. Out of them, 416 patients were diagnosed as uterus nwoma, 138 patients were uterus adenomyosis, 5 patients were eetopic pregnancy and 2 were postpartum hemorrhage. Meanwhile, the angiotomy, blood vessel imageology and the use of microcatheter of patients with ovarian dysfunction were discussed. [Results] Out of 554 patients with ovarian dysfunction, 56 patients developed to be different degree of ovarian dysfunction, the incidence was 10.1%, 6 patients happened amenonorrhea （1.1%）, 29 patients were metrorrhagia （5.2%）, and 27 patients were oligomenorrhea （4.9%）. 56 patients were treated with bilateral UAE. The reason of ovarian dysfunction was the embolism induced ovarian branches when the embolism agents was in the uterine artery. [Conclusion] Patients with gynecological benign diseases treated by UAE have risk of developing ovarian dysfunction. Unclear anatomy, non-proficiency operation and non-accurate discrimination of blood vessel were the main reason of developing ovarian dysfunction after treating with UAE.