子宫动脉栓塞治疗子宫肌瘤的初步研究

Preliminary experience with uterine artery embolization for uterine fibroids

目的 评价经导管子宫动脉栓塞法对子宫肌瘤的治疗作用。方法 28例病人(年龄36-48岁,平均41岁,)有子宫肌瘤,顽固性阴道出血和腹痛,用PVA微粒行子宫动脉栓塞。术后3-12个月(平均5月)通过调查评估临床症状的改善。术前和术后3个月CT测量子宫和主要肿块的大小。结果 所有28例病人在技术上均成功栓塞。28名患者中18名完成了调查表,显示症状明显好转的15例,无症状改善的1例,CT检查证实子宫体积和主要瘤体均大幅度缩小(平均缩小40％—65％)。结论 子宫动脉栓塞是一种很有希望的治疗子宫肌瘤导致的经血过多和盆腔疼痛的有效方法之一。

Purpose To evaluate the potential usefulness of transcatheter uterine artery embolization as a treatment for fibroid - related vaginal bleeding. Methods 28 patients (aged 36 - 49 years; mean, 41 years) with refractory vaginal bleeding and/or chronic pelvic pain related to u-terine leiomyomata underwent uterine artery embolization with use of polyvinyl alcohol (PVA) particles. Clinical improvement was assessed by detailed questionnaire at 3 - 12 months (mean, 5 months) after the procedure. CT measurements of the uterus and dominant masses were obtained before and at 3 months after the procedure. Results All 28 patients underwent technically successful embolization. Eighteen of twenty - eighty women who completed the follow - up questionnaire reported noticeable symptomatic improvement, including fifteen women with complete resolution of symptoms . One woman (the only patient undergoing unilateral embolization) exhibited no clinical response. Large reductions in uterine volume (average, 40%) and dominant fibroid size (average, 65%) were CT demonstrated. Conclusion Uterine artery embolization represents a promising new method of treating fibroid- related menorrhagia and pelvic pain. Further investigation will be required to define the optimal angiographic technique and PVA particle size.