葡聚糖微球经子宫动脉栓塞子宫肌瘤的临床疗效

The clinical application of uterine arterial embolization with dextran microspheres in treating uterine leiomyomas

目的前瞻性研究葡聚糖微球经双侧子宫动脉栓塞子宫肌瘤的临床疗效。方法将2003年1月至2010年12月收住的60例子宫肌瘤患者随机分为观察组和对照组,每组各30例。观察组30例患者用葡聚糖微球(Sephadex,G-50,100～300μm)行双侧子宫动脉栓塞术;对照组30例患者采用海藻酸钠微球(KMG,直径500～700μm)栓塞。观察两组患者在栓塞术前后月经量、子宫体积、肌瘤体积、性激素水平的变化以及住院费用的差异。结果两组插管栓塞成功率100%,术后平均随访6个月,两组患者月经量减少,子宫及肌瘤体积明显缩小,性激素无明显变化。上述各参数两组比较差异无统计学意义(均P>0.05)。葡聚糖微球栓塞组费用降低,两组间差异有统计学意义(P<0.05)。结论葡聚糖微球栓塞剂栓塞治疗子宫肌瘤是有效和安全的。而且价格低廉,值得临床开发应用。

Objective To prospectively investigate the clinical application of bilateral uterine arterial embolization with dextran mierospheres in treating uterine leiomyomas. Methods A total of 60 patients with uterine leiomyomas, encountered in the authors＇ hospital during the period from Jan. 2003 to Dec. 2010, were enrolled in this study. The patients were randomly divided into study group and control group with 30 cases in each group. Patients in the study group received bilateral uterine artery embolization by using dextran microspheres （Sephadex, G-50, 100 - 300 I^m） as embolic agents, while patients in control group received bilateral uterine artery embolization by using KMG （500 - 700 Ixm） as embolic agents. Before and after the treatment, all patients were kept under observation for the menstrual flow, the size of the uterine and the leiomyoma and the changes in sex hormone level. The hospitalization costs were recorded. The results were compared between the two groups. Results The technical success rate of catheterization and embolization procedure was 100% in both groups. After the therapy, the volumes of both the uterine and the leiomyoma were significantly decreased, but no significant difference in the size reduction existed between the two groups （both P 〉 0.05）. The clinical symptoms were markedly improved in all patients. The sex hormone level showed no obvious changes. No serious complications occurred. The hospitalization cost of the study group was significantly lower than that of the control group （P 〈 0.05）. Conclusion For the treatment of uterine leiomyomas, uterine artery embolization with dextran mierospheres is very effective and safe. Moreover, the hospitalization cost is lower. Therefore, it is of value to use this technique in clinical practice. （J Intervent Radiol, 2011, 20： 961-963）