经子宫动脉栓塞治疗子宫肌瘤疗效研究

Study the Treating Effect for Hysteromyoma with Uterine Artery Embolization

目的：研究平阳霉素碘化油乳剂经子宫动脉栓塞治疗子宫肌瘤的疗效，安全性和不良反应。方法：对127例子宫肌瘤患者进行超选择性子宫动脉栓塞治疗，所用材料为平阳霉素碘化油乳剂及明胶海绵颗粒，术后随访3～15个月，观察术后子宫大小与肌瘤体积的变化及不良反应。结果：102例行双侧子宫动脉栓塞，25例完成单侧栓塞，术中造影显示子宫动脉明显增粗，肌瘤滋养血管呈螺旋状，肌瘤染色明显。排空延迟。4例术后1周行子宫切除术。手术标本病理观察，肌瘤呈点片状坏死，小出血点。随访3个月症状缓解率达92％。其中子宫出血症状完全消失者占90．5％。盆腔胀痛及腹胀等压迫症状消失约占93％。肌瘤体积平均缩小84％。子宫体积缩小49．5％。结论：早期结果表明，平阳霉素碘化油乳剂行子宫动脉栓塞治疗子宫肌瘤疗法安全有效，并发症发生率低，是子宫肌瘤的较好治疗方法。

Objective：To study the safety and sdae effect of treating hysteromyoma by uterine artery embolization with pingyangmycin lipioddemulsion. Method： 127 cases hysteromyoma were underwent superselective uterine artery embolization with pingyangmycin lipiodol emulsion and golatin sponge. Then observed the side effect and size of uterine and hysteromyoma during the 3 to 15 months following up. Result： In all 102 eases with bilaterally and 25 cases one side uterine artery embolization . The angiography showed enlargement of rterine artery with spiral hypervasculature staining and prolonged opacifieution. 4 eases underwent hysterectomy after operation of one week. Thereg necrosis of pieces of hysteromyoma through the specimen pathology in operation. After 3 months following up. The alleviation rate of symptoms was 92% . The uterine hemorrhage was disappeared in 90.5 %. The pelvic edema and abdominal distention disappeared in 93%. The mean decreased of size of hysteromyoma was 84%. The readuction in size of uterine was 49.5%. Conclusion： It＇s safe and effective to treat hysteromyoma by uterine artery embolization with pingyangmyein lipiodol emulsion.