选择性子宫动脉栓塞术治疗子宫肌瘤的探讨

Study on selective arterial embolization in cases with uterine fibroid

目的评价选择性子宫动脉栓塞术治疗子宫肌瘤的临床疗效及应用价值。方法19例子宫肌瘤患者均采用经右侧股动脉穿刺双侧子宫动脉超选择性插管,使用聚乙醇+明胶海绵颗粒栓塞双侧子宫动脉,阻塞肌瘤血供。结果全部病例随访3～24个月,8例肌瘤体积缩小大于50%,9例肌瘤体积缩小20%～50%,月经量和月经周期恢复正常,1例缩小<20%,临床症状明显改善,1例无明显变化。治疗后3个月18例患者血红蛋白升至105g/L以上。无1例严重并发症发生。结论选择性子宫动脉栓塞术治疗子宫肌瘤是一种安全、简便、创伤小、疗效高的治疗方法,具有较高的临床应用价值。

Objective To evaluate the clinical effect and applicative value of selective embolization of uterine arteries in the treatment of uterine fibroid. Methods Nineteen women with uterine fibroid underwent right femoral artery puncture and transeatheter uterine artery embolization. The PVA and grain of gelfoam were introduced to embolize uterine artery and occlude the blood supply of fibroid. Results All cases were observed with a follow up of 3 to 24 months after treatment. The size of tumor in eight women were decreased more than 50%, the size of tumor in nine women were decreased by 20%-50%, the menorrhagia and menstrual cycles returned to normal. And the size of tumor in one woman was decreased less than 20%, the clinical symptoms meliorated. No clinical response exhibited in one case. The hemoglobin concentration of the eighteen patients rose up more than 105g/L 3 months after treatment. No severe complications were discovered in all cases. Conclusion Selective uterine artery embolization is a safe, simple method with less trauma and better curative effect, which has more clinical applicative value.