卵巢静脉栓塞术治疗盆腔淤血综合征

Ovarian vein embolizaton treatment of pelvic congestion syndrome

目的探讨采用卵巢静脉栓塞术治疗盆腔淤血综合征的疗效及安全性。方法回顾性分析因慢性盆腔疼痛（CPP）拟诊盆腔淤血综合征（PCS）的患者36例,对确诊为PCS的患者以弹簧栓子及聚桂醇泡沫硬化剂栓塞双侧卵巢静脉。术后随访12～52个月,评价应用卵巢静脉栓塞治疗PCS的技术方法、临床疗效及并发症发生情况。结果 28例患者确诊为PCS。对28例患者均成功栓塞双侧卵巢静脉,技术成功率为100%。栓塞相关并发症发生率为3.57%（1/28）。患者术中平均累积剂量为（80.7±23.7）m Gy,平均剂量面积乘积为（1677.7±570.9）c Gy·cm2。术后12个月,57.14%（16/28）的患者盆腔疼痛完全缓解,17.86%（5/28）的患者疼痛部分缓解,视觉模拟评分由术前（7.04±0.64）降至术后的2.04±2.87（P〈0.001）,术后12个月的总体临床有效率为75.00%（21/28）。随访过程中,4例患者疼痛症状复发,复发时间分别为栓塞后8、13、14及16个月。结论采用卵巢静脉栓塞术治疗PCS安全、有效。

Objective To evaluate the safety and efficacy of ovarian vein embolization for treatment of pelvic congestion syndrome（ PCS）. Methods The clinical data of 36 patients with the signs and symptoms of chronic pelvic pain（ CPP） were retrospectively analyzed. Patients diagnosed with PCS underwent bilateral ovarian veins embolization using coils and lauromacrogol foam,and were followed up for 12 to 52 months. The procedural details,clinical outcomes and complications of endovascular PCS treatment were evaluated. Results There were 28 patients diagnosed with PCS. The primary technical success rate was 100%with procedure-related complication rate of 3. 57%（ 1 /28）. The mean dose area product during fluoroscopy was（ 1677. 7 ±570. 9） c Gy·cm2and mean cumulated dose was（ 80. 7 ± 23. 7） m Gy. At 12 months,57. 14%（ 16 /28） of patients had no pelvic pain and 17. 86%（ 5 /28） reported a reduction in pelvic pain. The average visual analog scale was 7. 04 ± 0. 64 before embolization and 2. 04 ± 2. 87 at 12 months after intervention（ P〈0. 001）. The global clinical success was 75. 00%（ 21 /28） at 12 months. Four patients showed relapse of pelvic pain at 8,13,14,16 months. Conclusion Transcatheter embolization of insufficient ovarian veins is a safe and effective method for PCS.