达那唑海藻酸钠微球子宫动脉栓塞治疗子宫肌瘤和肌腺瘤的安全性和初步疗效探讨

A pilot study on the safety and clinic efficacy of uterine artery embolization with danazol alginate microspheres in the patients with myoma and/or adenomyosis

目的探讨使用达那唑海藻酸钠微球行子宫动脉栓塞术治疗子宫肌瘤和肌腺瘤的安全性和初步临床疗效。方法对16例子宫肌瘤和(或)肌腺瘤患者行达那唑海藻酸钠微球子宫动脉栓塞术,并于术后随访月经相关症状以及子宫和病灶体积的改变。结果平均随访时间11. 1个月,失访1例(6.3% )。 15例患者术后月经量均较术前明显减少,痛经患者的VAS分级术后均下降Ⅱ级以上,痛经症状评分平均下降8. 8～10. 4分。手术前后血红蛋白均值分别为(98. 2±21.0)和(118. 6±17. 1)g;子宫体积分别为(375. 6±251. 7)和(276. 1±286. 0) cm^3,子宫体积平均缩小(27. 7±31. 9)%。最大肌瘤或优势肌腺瘤体积分别为(164. 0±175. 57)和(116. 7±199. 0) cm^3,平均缩小(49.0±37.6)%;差异均有显著性。主要副反应栓塞后综合征,平均4周恢复正常生活。手术前后的卵巢功能测定差异无显著性。结论使用达那唑海藻酸钠微球行子宫动脉栓塞治疗子宫肌瘤和肌腺瘤具有较好的临床疗效。尚有待扩大样本的随机双盲对照研究进一步证实。

Objective： To investigate the safety and clinical outcomes of uterine artery embolization with danazol alginate microspheres in the patients with myoma or adenomyosis. Methods： Uterine arteries embolization with danazol alginate microspheres was applied to 16 women with myoma and/or adenomyosis. The main follow-up indices included the questionnaire for symptoms, hemoglobin level, visual analogue pain scale, uterine volume and tumor volume. Results： One patient was lost to follow-up. The mean follow-up period was 11. 1 months, with improved menstrual flow and visual analogue pain scale observed in all 15 patients. The relative symptoms of myoma and/or adenomyosis such as oppress symptoms, dyspareunia were also relieved after the treatment. The hemoglobin levels, uterine volume and tumor volume changed significantly. The main side effect was transient post-embolization syndrome. The recovery time was 4 weeks in average. The ovary function was not significantly altered. Conclusion： Using danazol alginate microspheres in uterine artery embolization for treating myoma and/or adenomyosis is safe and effective. A larger sample and a prospective randomized double blinded clinical trail are needed to verify these results.