经皮股动脉穿刺选择性子宫动脉栓塞治疗子宫肌瘤的临床研究

Percutaneous transfemoral artery selective uterine artery embolization for treatment of uterine myoma

目的 :研究用选择性子宫动脉栓塞法治疗子宫肌瘤的临床效果。方法 :采用Seldinger’s方法作选择性子宫动脉栓塞 ,治疗 3 0例子宫肌瘤。先经皮肤作股动脉穿刺 ,将动脉导管插至对侧髂内动脉 ,血管造影确认子宫动脉及肌瘤高度血管征象后 ,进行选择性子宫动脉插管 ,并通过动脉导管注入真丝线段 ,阻断肌瘤血供。 3～ 5天后同法作对侧子宫动脉栓塞治疗。结果 :血管造影发现 ,子宫肌瘤血供丰富 ,主要来自左右两侧子宫动脉 (占 93 % ) ,但以一侧为主要供血支 ,双侧子宫动脉栓塞完成后 ,子宫肌瘤血供可完全阻断。治疗后 6个月的随访结果表明 ,肌瘤均比治疗前缩小 ;月经周期恢复正常 ;月经量增多、贫血等症状明显改善。临床总有效率达 97%。结论 :选择性子宫动脉栓塞治疗子宫肌瘤是一种创伤小。

Objective:To assess the clinical effects of selective embolization of uterine arteries in treatment of uterine myomas.Methods:30 cases with symptomatic uterine myoma were treated by seldinger′s selective uterine arteries embolization.After a transcutaneous femoral arterial puncture,an artery catheter was inserted into the internal iliac artery of contralateral side and pelvic arteriography was performed to identify the uterine artery and the vasculature of myoma.The inert silk fragments were introduced through catheter to occlude the blood supply of myoma.3～5 days later the uterine artery of contralateral side was embolized by same procedure.Results:Arteriography showed that most aterine myomas were supplied by both uterine arteries (93%). When both uterine arteries were embolized,the blood supply of uterine myoma could be occluded.With a mean follow up of 6 months in the responders,the uterine myomas were reduced in size,menorrhagia controlled,menstrual cycles returned to normal and anemia resolved.Conclusions:Selective uterine embolisation is a new method for treatment uterine myomas with less trauma.