子宫动脉栓塞术治疗子宫肌瘤22例

Uterine arterial embolization therapy for 22 patients with hysteromyoma

目的 对不同类型子宫肌瘤进行子宫动脉栓塞治疗的临床应用研究 ,了解此方法疗效、副反应及并发症 ,探索治疗子宫肌瘤的新方法 .方法 对 2 2例以子宫出血、月经失常、贫血、下腹包块等为主要表现的子宫肌瘤患者进行双侧子宫动脉栓塞 (1次 ,碘化油用量以瘤染色消失为限 ) ,随访复查瘤体大小、出血多少、月经、贫血等方面的变化 .结果 随访 12 m o,瘤块均有不同程度的缩小 [其中 ,粘膜下肌瘤由术前 (8.7± 1.2 )cm缩小至 (2 .0± 0 .9) cm,P<0 .0 1;肌壁间肌瘤由术前 (7.2± 0 .8) cm缩小至 (1.4± 0 .4) cm,P<0 .0 1;浆膜下肌瘤由术前 (6 .4± 0 .9) cm缩小至 (2 .0± 0 .7) cm,P<0 .0 1],所有子宫出血病例 ,月经恢复正常 ;贫血病例 ,血红蛋白升至正常范围[其中 ,粘膜下肌瘤由术前 (7.2± 1.7) cm升至 (13.7± 1.9) g· L- 1 ,P<0 .0 1;肌壁间肌瘤由术前 (9.8± 0 .6 ) g· L- 1升至(13.6± 1.8) g· L- 1 ,P<0 .0 1;浆膜下肌瘤由术前 (10 .5± 1.2 ) g· L- 1 升至 (14.0± 2 .6 ) g· L- 1 ,P<0 .0 1].无严重并发症发生 .结论 子宫动脉栓塞术是治疗各类子宫肌瘤的安全、有效的新方法 ,对于想保留子宫、不愿手术、有手术禁忌证等情况的子宫肌瘤患者 ,不失为良好的选择 .

AIM To assess the curative effects, side effectsand complications of uterine arterial embolizartion therapy for hysteromyoma. METHODS Bilateral uterine arterial embolization (only once, moderate lipidol until the imaging of tumor disppeared) was performed on 22 patients suffering from hysteromyoma with the signs of uterine hemorrhage, anemia or abdomenal mass, menorhagia. Changes of the amount of uterine hemorrhage, the seriousness of anemia and the size of tumors were observed during follow-up checkups. RESULTS 12 months after the treatment, the tumors in all cases were found shrunk in varied degrees [submucous reduced from (8.7±1.2) to (2.0±0.9) cm, P <0.01; leiomyoma reduced from (7.2±0.8) to (1.4±0.4) cm, P <0.01; reduced from (6.4±0.9) to (2.0±0.7) cm, P <0.01]. Abnormal uterine hemorrhage and anemia disappeared [submucousd increased from (7.2±1.7) to (13.7±1.9) g·L -1 , P <0.01; leiomyoma increased from (9.8±0.6) to (13.6± 1.8) g·L -1 , P <0.01; subserous increased from (10.5± 1.2) to (14.0±2.6) g·L -1 , P <0.01]. No serious complications occurred. CONCLUSION Uterine arterial embolization, a safe and effective therapy, might be the first choice for the patients who are unwilling to run the risk of a surgery, to keep their utenus, or suffer from some contraindictions.