子宫动脉栓塞介入治疗子宫肌瘤临床疗效分析

Clinical effect of uterine artery embolization in the treatment of hysteromyoma

目的：探讨子宫动脉栓塞术介入治疗子宫肌瘤的临床效果及其对卵巢功能的影响。方法：选择46例经临床与影像学诊断为子宫肌瘤的患者,采用Seldinger技术,经皮股动脉穿刺,行双侧子宫动脉插管注入栓塞剂。术后3~6个月定期随访,观察介入治疗前后临床症状改善情况,子宫及子宫肌瘤体积大小,以及卵巢内分泌功能变化等。结果：46例患者均栓塞成功,术后临床症状明显改善;术前子宫及子宫肌瘤体积分别为（325.9±43.61）cm3和（57.4±19.47）cm3,术后3个月子宫与子宫肌瘤体积较介入治疗前分别缩小40.1%和38.5%,术后6个月分别缩小52.0%和67.2%,差异均有统计学意义（P〈0.01）;雌二醇、卵泡刺激素以及黄体生成素水平介入治疗前后差异均无统计学意义（P〉0.05）。结论：子宫动脉栓塞介入治疗子宫肌瘤可明显改善患者临床症状,子宫及子宫肌瘤体积较治疗前均明显缩小,且不影响卵巢的正常生理功能。

Objective：To evaluate the therapeutic effects of uterine artery embolization on hysteromyoma and its influence on ovarian function. Methods：The embolization agents were injected into the bilateral uterine arteries of 46 patients with hysteromyoma using the Seldinger technique via the percutaneous femoral arterial catheterization. All patients were followed up for 3 to 6 months. The clinical symptoms,volume of uterus and hysteromyoma and ovarian endocrine function in all cases were observed before and after interventional therapy. The volume of uterine and hysteromyoma and level of hormone（ E2,FSH and LH） of ovary were measured before and after uterine artery embolization. Results：The uterine artery embolization in 46 patients were successful,the symptoms of all cases were significantly improved. The average volumes of uterus and hysteromyoma were（325. 9 ± 43. 61） cm3and（57. 4 ± 19. 47） cm3 before treatment,respectively. The volumes of uterus and hysteromyoma shrunk 40. 1% 38. 5% and 52. 0% 67. 2% in 3 and 6 months after embolization,respectively,the differences of which were statistically significant（ P〈0. 01）. The differences of the levels of E2,FSH and LH between before and after treatment were not statistically significant（P〉0. 05）. Conclusions：Uterine artery embolization can significantly improve the clinical symptoms and shrink the volumes of uterus and hysteromyoma,which does not affect the physiological function of ovary.