子宫动脉栓塞治疗子宫腺肌症的长期随访研究

Uterine artery embolization for adenomyosis long-term follow-up study

目的观察子宫腺肌症患者介入治疗后的长期效果。方法对39例子宫腺肌症患者进行聚乙烯醇微粒和明胶海绵碎粒双侧子宫动脉栓塞。术后随访2年,观察月经及子宫体积等变化情况。结果全部患者行双侧子宫动脉栓塞成功。31例术后3月痛经完全消失,8例痛经减轻,较介入治疗前患者疼痛评分明显降低;所有患者月经量平均减少42%(P<0.01);超声见子宫病灶消失34例(87.2%),明显缩小5例(12.8%)。随访2年,痊愈31例(79.5%),好转8例(20.5%)。随访期间2例于术后9、11个月因人工流产后复发。1例术后10个月出现痛经加重,腹腔镜手术证实为盆腔炎性包块,术后随访至12个月,无异常。复发率为7.7%;妊娠8例(20.5%)。结论通过2年的随访观察,介入治疗子宫腺肌病在保留了子宫和生育能力的同时还具有创伤小、症状缓解迅速,不易复发等优点。

Objective To investigate the involvement of adenomyosis in patients with long - term effects after treatment. Methods 39 cases of uterine adenomyosis in patients with alcohol and gelatin sponge particles crushed bilateral uterine artery embolization. Were followed up for 2 years, observation and other menstrual and uterine volume changes. Results All patients succesfully underwent bilateral uterine artery embolization. 31 cases of dysmenorrhea disappeared 3 months after,and 8 to reduce dysmenorrhea, compared with before intervention in patients with pain scores were significantly lower; average reduction of menstrual flow in all patients 42% （ P 〈 0. 01 ） ; seeing the uterus under ultrasound lesions disappeared in 34 patients （87.2%）, significantly reduced in 5 cases （ 12. 8% ）. 2 - year follow - up, cured 31 patients （79.5%）, improved in 8 cases （20. 5% ）. 2 cases during the months after the operation for 9,11 recurrence after abortion. 1 case re - emerged in October after increasing dysmenorrhea, laparoscopic surgery confirmed pelvic inflammatory mass, patients were followed up in December has been no exception. Recurrence rate was 7.7% ; pregnancy in 8 cases （20. 5% ）. Conclusion By 2 years of follow - up observation, intervention of adenomyosis in the uterus and fertility preserved, while still with less trauma and rapid relief of symptoms, less recurrence and so on.