TUEA治疗妇科良性疾病对卵巢功能及子宫肌层的影响

Effect of uterine arterial embolization on ovarian function and myometrium in treatment of gynecological benign diseases

目的:探讨对子宫肌瘤、子宫腺肌病患者实施子宫动脉栓塞治疗(TUEA)后对患者的卵巢功能及子宫的影响。方法:对67例子宫肌瘤、子宫腺肌病患者进行TUAE治疗,并对患者进行为期12个月的随访观察,比较患者治疗前、治疗后第3个月、第6个月、第12个月的雌二醇(E2)、促黄体生成素(LH)、卵泡生成素(FSH)、孕酮(P)的水平变化,并采用磁共振加权成像对治疗前后子宫肌层情况进行比较。结果:治疗前、治疗后第3、6、12个月的E2、LH、FSH比较差异具有统计学意义(F=26.69、15.54、20.89,P<0.001),治疗后各个时期的E2、LH、FSH均显著的低于治疗前(P<0.05);治疗前,MRI检测发现肌瘤部位的ADC值在b=0、350 s/mm2和b=0、700 s/mm2分别为(1.84±0.13)×10-3mm2/s和(1.72±0.15)×10-3mm2/s,与周围正常肌层组织差异均具有统计学意义(t=24.99、18.92,P<0.001);治疗前与治疗后不同时间的ADC值比较差异均具有统计学意义(F=23.60、16.49,P<0.001);治疗后各个时期的ADC值均较治疗前显著减小(P<0.001)。结论:TUEA治疗对子宫肌瘤、子宫腺肌病能够取得较好的治疗效果,同时不会对患者的卵巢及子宫功能造成严重影响。

Objective： To explore the effect of uterine arterial embolization on ovarian function and myometrium in treatment of u- terine fibroids and adenomyosis. Methods： Uterine arterial embolization was conducted among 67 patients with uterine fibroids and adeno- myosis, then the patients were followed up for 12 months; the changes of levels of estradiol, luteinizing hormone （LH） , follicle stimulating hormone （FSH） and progesterone before treatment and at 3, 6 and 12 months ＇after treatment were compared; MRI was used to compare myo- metrium before and ＇after treatment. Results： There were statistically significant differences in the levels of estradiol, LH and FSH before treatment and at 3, 6 and 12 months after treatment （F =26. 69, P 〈0. 001 ; F = 15.54, P 〈0. 001 ; F =20. 89, P 〈0. 001 ）, the levels of estradiol, LH and FSH at 3, 6 and 12 months after treatment were statistically significantly lower than those before treatment （P 〈 0. 05 ） ; before treatment, ADC values of cervical lesions were （ 1.84 ± 0. 13） × 10^-3 mm^2/s and （ 1.72 ±0. 15） × 10^-3 mm^2/s respectively when b values were 350 s/mm^2 and 700 s/mm^2 , respectively, compared with adjacent normal myometrium, there were statistically significant differences （t = 24. 99, P 〈 0. 001 ; t = 18.92, P 〈 0. 001 ） ; there were statistically significant differences in ADC value between before treatment and at 3, 6 and 12 months after treatment （F = 23.60, 16.49, P 〈0. 001） ; at 3, 6 and 12 months after treatment, ADC values decreased significantly compared with before treatment （P 〈 0. 001 ） . Conclusion： The curative effect of uterine arterial embolization is good in treatment of uterine fibroids and adenomyosis, meanwhile, it has no serious impact on ovarian and uterine function of the patients.