超声引导下瘤内无水乙醇注射治疗子宫肌瘤的初步研究

Preliminary of percutaneous ethanol injection to uterine leiomyoma directed by ultrasound.

目的 观察超声引导下经皮无水乙醇注射 (PEIT)治疗子宫肌瘤的疗效。方法 对 2 5例子宫肌瘤患者采用超声引导下PEIT治疗。 10例行PEIT 5天后手术切除肌瘤 ,观察肌瘤内坏死情况 ;15例在行PEIT后定期观察肌瘤体积及内部血流变化。结果 10例手术组 5例注射无水乙醇 3ml者 ,肌瘤中央坏死范围直径约 2cm ,另 5例注射 5ml者 ,坏死范围直径约 3cm ;未手术组注射治疗前平均肌瘤体积 10 5 5cm3 ,2个月后缩小为 74 6cm3(P <0 0 1) ;6个月后体积未再增大 (6 2 4cm3 ,P >0 0 5 ) ,彩超显示肌瘤内部及周边血流明显减少。结论 PEIT治疗子宫肌瘤灭瘤效果确实 ,近期疗效满意 ,有关远期疗效及剂量与效果的关系正进行深入研究。

Objective To investigate the effectiveness of percutaneous ethanol injection treatment(PEIT) in uterine leiomyoma.Methods Ultrasound guided PEIT was performed in 25 patients with uterine leiomyoma.Myomatectomy was undergone in 10 of the 25 patients five days after PEIT.In other 15 patients the volume and the blood flow of the injected leiomyoma in the second and the sixth month after PEIT were monitored with color doppler ultrasound.Results The pathologic examination showed that the diameter of necrotic area in the center of the injected leiomyoma was about 2cm in five cases with the dosage of ethanol 3ml,and 3cm in another five cses with the ethanol dosage of 5ml.In non-operated cases,the average volume of the injected leiomyoma before PEIT(105 5cm 3) decreased significantly after two months of PEIT (74 6cm 3)(P<0 01),and it remained unchanged six months later after PEIT (62 4cm 3)(P>0 05).The blood flow within the leiomyoma decreased immediately after PEIT.Conclusion PEIT has a confirmed and satisfactory effectiveness to reduce the volume of uterine leiomyoma and may be used to treat such benign tumor.Further study will focus on the relationship between the efficiency and the dosage of ethanol.