选择性子宫动脉栓塞术在症状性子宫肌瘤中的应用

Selective uterine artery embolization:its application in treating symptomatic uterine leiomyomas

目的探讨选择性子宫动脉栓塞术治疗症状性子宫肌瘤的疗效和安全性。方法 2005年1月至2009年6月在复旦大学附属妇产科医院就诊的85例症状性子宫肌瘤行子宫动脉栓塞术,症状包括月经量增多、经期延长和邻近器官压迫为主要症状的子宫肌瘤患者,通过超选择性双侧子宫动脉插管,以直径500～710μm的聚乙烯醇颗粒和明胶海绵栓塞子宫动脉。结果栓塞成功率达100%,无严重并发症。随访6～36个月,所有病例月经恢复正常;贫血病例,血红蛋白升至正常范围。术后6个月肌瘤平均缩小57.5%。结论子宫肌瘤栓塞治疗创伤小,保留子宫,并发症少,是临床效果确切的一种新治疗方法。

Objective To discuss the feasibility and safety of uterine artery embolization（UAE） for the treatment of symptomatic uterine leiomyomas.Methods During the period of Jan.2005-June 2009,UAE was performed in 85 patients with uterine leiomyomas in the authors＇ hospital.The main symptoms included hypermenorrhea,delayed menstruation and pelvic pressure symptoms.The bilateral uterine arteries were embolized with polyvinyl alcohol particles（diameter 500-710 μm） and Gelfoam.The technical success rate and the clinical results were observed.The patients were followed up for 6-36 months.Results The technical success rate of bilateral uterine artery embolization was 100%.No serious complications occurred.During the follow-up period,menses returned to regular cycle in all patients and the hemoglobin concentration rose up to normal level in patients with anemia.The sizes of uterine leiomyomas were decreased by 57.5% after 6 months of the procedure.Conclusion UAE is an effective and less-invasive treatment for symptomatic uterine leiomyomas with reliable results and fewer complications.This technique can greatly avoid unnecessary uterectomy and,thus,preserve the fertility of the female patients.