介入栓塞术对子宫肌瘤患者子宫血供及卵巢功能的影响

Effect of interventional embolization on the uterine blood supplyand ovarian function of patients with uterine fibroids

目的:探讨介入栓塞术对子宫肌瘤治疗前后子宫血供变化情况的影响。方法:选择2014年6月至2015年6月我院妇科接诊的40例子宫肌瘤患者,对所有患者进行子宫动脉介入栓塞术进行治疗,观察治疗前后子宫肌瘤内部和子宫肌瘤周边的血供参数、子宫体积、子宫肌瘤体积、平均月经量、平均月经期以及卵巢中相关激素的变化情况。结果:患者治疗后子宫肌瘤内部血供中的收缩期峰值流速(4.15±0.64)cm/s、平均流速(1.95±0.41)cm/s、最粗供血动脉管径(8.22±1.10)mm均低于治疗前[(21.38±4.39)cm/s、(12.58±2.14)cm/s、(31.14±3.42)mm],阻力指数(0.98±0.10)得到上升(0.51±0.05),子宫肌瘤周边血供中的收缩期峰值流速、平均流速、最粗供血动脉管径也低于治疗前,阻力指数高于治疗前,差异具有统计学意义(P<0.05);治疗后子宫体积和子宫肌瘤体积(154.32±25.28,17.84±5.95)cm3明显小于治疗前(326.87±43.64,57.59±15.48)cm3,平均月经量(47.23±9.51)m L和平均月经期(4.76±1.09)d低于治疗前[(86.84±17.48)m L、(7.83±1.52)d],治疗前后相比,差异具有统计学意义(P<0.05)。结论:介入栓塞术可以有效的降低子宫肌瘤患者的血供情况,不仅保留了子宫,还能良好的保护患者的卵巢功能,值得在临床上应用推广。

Objectives： To investigate the effect of interventional embolization on the changes of uterine blood supply before and after the treatment of uterine fibroids. Methods： 40 patients with uterine fibroids in our hospital from June 2014 to June 2015 were selected and treated with interventional embolization. The blood supply parameters,uterine volume,the volume of uterine fibroids,the average menstrual volume,the average menstrual period,and the changes in related hormones were observed. Results： The peak flow velocity（ 4. 15 ± 0. 64） cm / s,average flow velocity（ 1. 95 ± 0. 41） cm / s and the diameter of the most crude blood supply artery（ 8. 22 ± 1. 10） mm were lower than those before treatment [（ 21. 38 ± 4. 39） cm / s,（ 12. 58 ± 2. 14） cm / s,（ 31. 14 ± 3. 42） mm]; the resistance index（ 0. 98 ± 0. 10） was increased（ 0. 51 ± 0. 05）; the peak flow velocity,average flow velocity and the diameter of the blood supply in the peripheral blood supply of uterine fibroids were lower than those before treatment,and the resistance index was higher than before treatment,all with statistically significant difference（ P〈0. 05）. After treatment,uterine volume and uterine myoma volume（ 154. 32 ± 25. 28,17. 84 ± 5. 95） cm3 were significantly smaller than before treatment（ 326. 87 ± 43. 64,57. 59 ± 15. 48） cm3）; the average menstrual volume（ 47. 23 ± 9. 51） ml and the average period（ 4. 76 ± 1. 09） d were lower than before treatment,[（ 86. 84 ± 17. 48）ml,（ 7. 83 ± 1. 52） d],both with statistically significant difference（ P〈0. 05）. Conclusions： Interventional embolization can effectively reduce the uterine blood supply of patients with uterine fibroids,which not only retains the uterus,but also protects ovarian function,thusly worthy of promotion in clinical application.