不同栓塞材料介入治疗子宫肌瘤的临床应用分析

Analysis on clinical application of different embolism agents in the uterine arterial embolization

目的探讨不同栓塞材料在子宫动脉栓塞术(uterine artery embolization,UAE)治疗子宫肌瘤中的应用价值。方法 94例子宫肌瘤患者行选择性双侧子宫动脉插管造影栓塞治疗,随机分为3组,采用不同栓塞材料:真丝线段(natural silk segment,SS)栓塞组32例,聚乙烯醇(polyvinyl alcohol,PVA)栓塞组30例,平阳霉素(pingyangmycin,PLE)碘油乳剂+明胶海绵栓塞组32例。术后随访6个月,观察临床症状改变、肌瘤体积变化、术后不良反应及并发症。结果 3组患者术后贫血、月经量多、压迫症状较术前均有不同程度改善,肌瘤均有不同程度缩小(P<0.05);不良反应及并发症3组间比较差异无统计学意义(P>0.05)。结论 SS和PLE碘油乳剂+明胶海绵颗粒行UAE治疗具有良好的疗效和安全性,可作为PVA的替代物,尤其适用于基层医院。

Objective To investigate application value of different embolism agents in uterine artery embolization（ UAE） . Methods A total of 94 patients underwent UAE,which were randomly divided into 3 groups, using natural silk segment（ Group SS,32 cases） ,polyvinyl alcohol（ Group PVA,30 cases） and pingyangmycin lipiodol emulsion＋gelatin sponge（Group PLE,32 casess） respectively. With 6 months of follow up,the clinical symptoms, tumor volumes,postoperative side effects and complications were observed. Results The symptoms of patients in 3 groups as anemia,menorrhagia et al alleviated compared to pre-operation. The volume of uterine leiomyoma of all cases decreased to some extent（P〈0. 05）. There were no significant difference among 3 groups in the incidence of side effects and complications（P〉0. 05）. Conclusion Silk segment and pingyangmycin lipiodol emulsion＋gelatin sponge have a good efficacy and safety in UAE, which can replace PVA as a good agent of arterial embolization,＆amp;nbsp;especially suitable for primary hospital.