碘油平阳霉素乳剂和聚乙烯醇颗粒栓塞子宫肌瘤的临床研究

Embolization therapy of uterine fibroids by using pingyangmycin lipiodol emulsion or polyvinyl alcohol particles:a clinical comparative study

目的评价碘油平阳霉素乳剂和聚乙烯醇颗粒(PVA)栓塞子宫肌瘤的疗效及安全性。方法回顾分析73例经碘油平阳霉素乳剂或PVA治疗的子宫肌瘤患者的资料,分成两组进行比较,其中A组(29例)采用碘油平阳霉素乳剂作为栓塞剂,B组(44例)采用PVA(直径300～700μm)作为栓塞剂,观察手术并发症,比较术前及术后6个月的子宫体积、肌瘤体积及性激素变化情况。结果A、B两组插管栓塞成功率100%,术后子宫及肌瘤体积均明显缩小,两组比较差异无统计学意义(P>0.05);两组患者术后症状明显改善,栓塞前后性激素无明显变化,两组比较差异无统计学意义(P>0.05);无严重并发症。结论碘油平阳霉素乳剂与PVA是治疗子宫肌瘤的安全、有效的栓塞材料,但平阳霉素是化疗药物,为避免近、远期的潜在并发症,使用PVA作为栓塞剂更安全。

Objective To evaluate the efficacy and safely of embolization of uterine fibroids by using pingyangmycin lipiodol emulsion or polyvinyl alcohol particles as embolismie materials. Methods Seventythree patients with uterine fibroids were divided into two groups. Patients in group A （29 eases） were treated with pingyangmycin lipiodol emulsion as emholismie materials, while patients in group l] （44 eases） with polyvinyl alcohol particles （with a diameter of 300-700μm） as embolismie materials. Embolization therapy of uterine fibroids was performed in all patients. The uterus volume, the size of uterine fibroid and sex hormone level both before and after the treatment were estimated and the results were compared between two groups.The oceun-ence of complications was obseB, ed. Results The technical success of catheterization and embolization was 100% in both groups. After the therapy, both the uterus volume and the uterine fibroid size decreased significantly, but no significant difference in the size reduction existed between the two groups（P 〉 0.05 ）. The clinical symptoms showed a marked improvement in all patients, while the sex hormone level showed no obvious changes. No serious complications occurred. Conclusion In treating uterine fibroids with embolization technique, both pingyangmycin lipiodol emulsion and polyvinyl alcohol particles are safe and effective embolismic materials. However, use of polyvinyl alcohol particles may be safer than pingyangmycin, as pingyangmycin is a kind of chemotherapeutic drugs, which might potentially cause some short-term or long-term complications.