平阳霉素碘油乳剂子宫动脉栓塞治疗子宫腺肌症的临床研究

Treatment of adenomyosis by uterine arterial embolization with Pingyangmycin-lipiodol emulsion

目的探讨平阳霉素碘油乳剂(PLE)子宫动脉栓塞治疗子宫腺肌症的疗效。方法25例经临床、B超、CT和MRI诊断明确的子宫腺肌症患者,根据子宫动脉造影,行PLE双侧子宫动脉栓塞,平阳霉素平均用量为(8.5±3.2)mg,超液化碘油平均用量为(5.5±2.0)mL。结果25例患者进行了25次子宫动脉栓塞术,手术成功率100%,PLE在病变区域沉积良好。痛经完全缓解率为90%(18/20),月经异常者合并贫血完全缓解率为86.7%(13/15)。血红蛋白术前平均为(102.4±25.0)g/L,术后为(119.5±13.2)g/L(<0.01);CA-125术前平均为(191.8±112.5)U/mL,术后为(84.2±60.4)U/mL(<0.01)。术前B超检查子宫体积大小平均为(382.4±196.1)cm3,术后为(185.1±74.2)cm(3<0.01)。未见与子宫动脉栓塞有关的子宫坏死等严重并发症发生。结论PLE子宫动脉栓塞治疗子宫腺肌症微创安全有效,能较好控制或缓解痛经等相关症状,达到缩小子宫,调整月经异常。

Objective To evaluate the curative effect of the treatment of uterine arterial embolization （UAE） with Pingyangmycin-lipiodol emulsion （PLE） on adenomyosis. Methods There were 25 cases of patients who suffered from adenomysis diagnosed by B ultrasound, CT or MRI. Bilateral uterine arterial embolization were undergone with PLE to these patients according to uterine arteriography. The average dosages of pingyangmycin was （8.5±3.2）mg, and the average dosages of lipiodol was （5.5±2.0）mL. Results Twenty-five times of UAE were done to 25 patinets. The success rate of uterine artery catherization was 100%. The complete relieve rate about dysmenorrhoea was 90% （18/20）. When to menorrhagia, it was86.7% （13/15）. The preopration average HGB was （102.4±25.0）g/L, and the postoperation was （119.5±13.2）g/L; the preoperation average CA-125 was （191.8±112.5）U/mL, and the postoperation was （84.2±60.4）U/mL; the preoperation average uterine volume checked by B ultrasound was （382.4±196.1）cm^3, and the postoperation was （185.1±74.2）cm^3. There were significant differences on statistics about the pre- and postoperation average HGB, CA-125 and uterine volume （P〈0.01）. No complications of UAE occurred. Conclusion UAE with PLE has the feature of less trauma and more safety. It also can get good curative effect. The related symptom of adenomysis can be controlled or relieved through UAE. The uterine volume can also be decreased.