子宫肌瘤大小、数目、位置对介入治疗效果的影响

Effect of the size,number or location of fibroids on therapeutic efficacy of uterine artery embolization

目的：评估子宫肌瘤大小、数目、位置对介入栓塞治疗子宫肌瘤效果的影响。方法选取行子宫肌瘤介入栓塞治疗的患者84例，分别按照子宫肌瘤的大小、数目、位置分组，用 PVA 颗粒、明胶海绵颗粒行子宫动脉栓塞术，术后所有患者门诊随访，了解患者症状改善情况，并行影像学检查。结果所有患者均成功行介入栓塞手术，手术成功率100％。术后12个月成功随访患者77例，均未出现严重并发症，且多数患者自觉症状改善明显。所有患者肌瘤体积和子宫体积在手术后均明显缩小（t ＝5．842，P ＜0．05）。进一步比较显示，不同大小的肌瘤术后体积缩小率差异无统计学意义，子宫体积缩小率差异亦无统计学意义。单发肌瘤手术后肌瘤缩小率和子宫缩小率与多发肌瘤相比，差异无统计学意义。三种不同位置的子宫肌瘤手术后子宫缩小率和肌瘤缩小率差异无统计学意义。结论子宫动脉栓塞术是一种有效地治疗子宫肌瘤的方法，在该研究中，子宫肌瘤大小、数目、位置均不会影响症状的改善、术后并发症的发生率等。

Objective To evaluate whether the size,number or location of fibroids affect therapeutic efficacy of uterine artery embolization （UAE）.Methods 84 patients with symptomatic uterine fibroids who had received uterine fibroid embolization with the use of polyvinyl alcohol（PVA）or gelfoam sponge particles（GSP）.According to the lesion＇s size,number or location,all patients were divided into different groups and following -up as outpatients. Patient＇s symptomatic improvement and imaging following -up was assessed after UAE.Results A technically suc-cessful embolization was done in all patients.Postoperative 12 -month following -up was performed in 77 cases.No major life -threatening complications were found and the clinical symptoms were improved after UAE.In the different groups,the uterine size and the leiomyoma size after UAE were markedly decreased（t =5.842,P 〈0.05）.Further comparison showed that the mean reduction in fibroids volume after UAE was not significant between the two groups, so was the mean reduction in uterine volume.Solitary leiomyoma group showed no significant difference in volume reduction rate of fibroids and uterine after UAE as compared with multiple leiomyoma group.Changes were not signifi-cantly in Submucosal uterine fibroids,Subserosal uterine fibroids,Intramural uterine fibroids.Conclusion UAE is an effective treatment for uterine fibroids.In this study,the size,number,and location of fibroids did not affect therapeutic efficacy or the complication rate of UAE.