经导管子宫动脉栓塞治疗症状性子宫平滑肌瘤的初步经验

Transcatheter uterine arterial embolization for the treatment of symptomatic uterine fibroids: preliminary experience

目的 评价经导管子宫动脉栓塞 (UAE)对症状性子宫平滑肌瘤 (UF)的疗效并探讨治疗技术。方法 10例患者主要症状包括阴道出血 (月经过多 ) ,盆腔压迫症状 (尿频 ) ,盆区疼痛。UF的诊断经影像学检查和专科医师检查确定 ,并排除与症状有关的其它妇科疾病。 10例患者行 11例次子宫动脉栓塞 ,其中双侧者 10例次 ,单侧者 1例次。栓塞剂为PVA微球。结果 栓塞技术成功率为 10 0 % ,无严重并发症。随访 9例 ,术后症状有明显改善者 8例 ,无明显效果者 1例 ,与仅行单侧栓塞有关。术后 2个月肿瘤体积平均缩小 42 %。结论 UAE是治疗UF的安全方法 ,近期疗效优良 ,远期疗效尚有待观察。

Objective To evaluate the effectiveness of uterine arterial embolization (UAE) in the mana gement of symptomatic uterine fibroids (UF). Methods Ten patients with refractory vaginal bleeding, pelvic pain, and/or pelvic compression related to UF underwent UAE. The UF was diagnosed by radiological imaging and gynecological examination. 11 times of UAE were done in the ten patients, including bilateral uterine arterial embolization in 9 patients and unbilateral embolization in 1 patient. The embolic materials used in this study was polyvinyl alcohol (PVA) particles. Results All 10 patients underwent technically successful embolization. No serious complications related to the procedure have occurred. Follow up data was available in 9 patients. Eight of the patients were experienced symptomatic relief after the treatment. One woman (the only patient undergoing unbilateral UAE) exhibited no clinical respose. The volume of dominant UF showed a mean 42% reduction sonographically 2 months after the treatment. Conclusions Transcatheter uterine arterial embolization is a safe and effective method for the management of symptomatic UF. Longer follow up is needed to evaluate the long term effects.