子宫动脉栓塞术在子宫腺肌病治疗中的应用

Uterine arterial embolization in the treatment of adenomyosis

目的 探讨子宫动脉栓塞术治疗子宫腺肌病的临床疗效。方法 对 2 3例根据临床症状、彩色超声或磁共振成像检查诊断为子宫腺肌病的患者 ,行子宫动脉栓塞术治疗。应用 4～ 5F脾管或肝管或Cobra管或 3F微导管完成双侧子宫动脉插管 ,以混有抗生素的新鲜明胶海绵颗粒 (直径1～ 3mm)栓塞。术后观察月经量、痛经程度及子宫体积等变化。结果 治疗后平均观察 (16± 3)个月经周期 ,临床症状缓解率 92 %。其中 ,月经量减至术前的 (5 0± 18) % ,月经周期、经期无变化 ;19例患者术后痛经完全消失 ,2例明显缓解 ,2例复发 ;术后疼痛评分及痛经分级比术前明显降低 (P<0 0 1) ;子宫体积平均缩小 37% ;彩色超声检查子宫肌层及病灶内血流信号明显减少。结论 子宫动脉栓塞术治疗子宫腺肌病近期疗效显著 ,安全性好 ,患者接受程度高。

Objective To assess the clinical efficacy of uterine arterial embolization(UAE) in the treatment of adenomyosis Methods UAE procedures were performed in 23 patients with adenomyosis Two 3 0 F FASTRACKER 325 tubes were placed into bilateral uterine arteries respectively and the fresh gelfoam particles mixed with antibiotic drugs were used to embolise the arteries After treatment the symptoms and uterine volume of all patients were investigated Results All clinical symptoms of 23 patients relieved Dysmenorrhea completely disappeared in 19 patients, significantly alleviated in 2 patients But in other 2 recurred The uterine volume shrunk significantly [(50±18)%] vs [(100±0)%] The blood flow within the uterine and lesions detect by color doppler flow imaging decreased immediately after UAE Low abdominal pain and slight fever were seen after treatment and recovered within 1 2 weeks Conclusion UAE is an effective and safe method in the treatment of adenomyosis