子宫肌瘤病理血管彻底性栓塞治疗的临床研究

Clinical study of uterine tibroid arterial embolization with PVA particles

目的 研究用聚乙稀醇颗粒 (PVA)彻底栓塞子宫肌瘤病理血管的临床效果。方法 对30例子宫肌瘤患者通过超选择性两侧子宫动脉插管 ,用直径为 2 5 0～ 35 5 μm的PVA 10 0～ 2 5 0mg将子宫肌瘤病理血管彻底栓塞。结果 30例栓塞成功率 96 .7% ,随访 3～ 12个月。术后第 1个月月经恢复正常 2 6 /2 7例 ;贫血好转 2 0 /2 1例 ;下腹部坠痛不适减轻 15 /17例 ;肿块消失 1/3例 ;肿瘤压迫症状全部消失。术后 3个月瘤体平均缩小 40 %以上 ;术后 6个月瘤体平均缩小 5 0 %以上 ,其中 2例完全消失 ;术后 9个月瘤体平均缩小 6 0 %以上 ,其中 3例完全消失 ;无 1例出现严重并发症。结论 超选择性两侧子宫动脉插管将肌瘤病理血管用PVA彻底栓塞是子宫肌瘤安全。

Objective To evaluate clinical efficacy of uterine fibroid arterial embolization with PVA particles.Methods After selective catheterization of the bilateral uterine arteries, 30 cases with uterine fibroid were cured by uterine fibroid pathologic vessel embolization with 100～250mg PVA particles of 250～350μm. Results 96.7% of 30 cases were technically successful, followed up for 3～12 months, averaged 8 months. One month afterward, menstrual bleeding was improved in 26/27 cases, anemia was improved in 20/21 cases, pelvic pain and pressure were decreased in 15/17 cases, compression symptoms of tumor were completely disappeared, loss of tumor mass in 1/3 cases. Uterine fibroid volume decreased of more than 40% at 3 months, decreased of more than 50% at 6 months (fibroids of 2 cases were completely disappeared), decreased of more than 60% at 9 months after the procedure (fibroids of 3 cases were completely disappeared). No serious complication occurred. Conclusions Uterine fibroid pathologic vessel embolization with PVA particles was a safe and efficient method.