子宫动脉栓塞术治疗子宫肌瘤42例临床分析

Clinical analysis of 42 cases uterine myoma by uterine arterial embolization

目的 探讨子宫动脉栓塞术 (UAE)治疗子宫肌瘤的疗效。方法 选择 42例子宫肌瘤患者 ,以Seldinger技术完成单侧股动脉插管 ,根据数字减影血管造影 (DSA)检查结果 ,选用管径为 4～5F (1F =0 33mm)的脾管、肝管或cobra导管 ,或选用 3F微导管 ,插管至双侧子宫动脉并经DSA检查证实后 ,以携带有抗生素的明胶海绵颗粒栓塞该处血管。结果 DSA检查发现 ,子宫肌瘤血液供应丰富。UAE治疗 6～ 12个月后 ,子宫肌瘤患者的临床症状明显缓解 ,月经量减少 2 6 3%～ 75 2 % ;UAE治疗后第 12个月、第 18个月肌瘤体积分别缩小 77 7%、83 0 % ,子宫体积分别缩小 5 4 9%、6 2 7%。术后有不同程度的下腹痛、低热 ,持续 1～ 3周 ,经对症处理后症状逐渐消失。结论 UAE可有效地缩小肌瘤及子宫的体积 。

Objective To assess the clinical effects and side effects of uterine arterial embolization(UAE) on uterine myoma. Methods UAE was performed in 42 patients with uterine myoma. The 4～5 F cobra catheters were insered into the uterine arteries for treatment. Gelfoam particles mixed with antibiotics were used to embolize the arteries. All patients were followed upto 18 monthes post operation. Results Arteriography showed that uterine myoma was mainly supplied by uterine arteries and partly by ovarian arteries. All clinical symptoms of 42 patients were relieved. Menorrhagia was reduced 26.3%～75.2%. The volume of uterus myoma decreased 77.7% and 83.0% 12 and 18 months after UAE,respectively and the volume of uterine decreased 54.9% and 62.7%. Conclusions UAE was an effective and satisfactory method for the treatment of uterine myoma. Further effects of it should be observed continuously and periodically.