子宫肌瘤动脉介入治疗

Uterine Artery Embolization for Uterine Fibroids

目的 评价子宫动脉栓塞治疗子宫肌瘤的疗效和并发症 .方法 对 2 7例子宫肌瘤患者进行子宫动脉栓塞治疗 ,随访复查子宫、瘤体大小变化和临床症状、并发症的情况 .结果 子宫动脉栓塞后随访 3～ 18个月 ,有效率为92 .6 % (2 5 / 2 7) .月经过多的改善率 89.5 % (17/ 19) ,痛经改善率 88.9% (8/ 9) ,子宫体积减少 4 8.9± 15 .6 % (t =13.392 1,p<0 .0 0 1) ,肌瘤体积减少 5 6 .8± 17.9% (t =14 .6 4 0 3,p <0 .0 0 1) ;并发症发生情况 :轻中度发热 2 0 / 2 7(74 1% )、中重度腹痛 5 / 2 7(18.5 % )、月经周期缩短 10 / 2 7(37 0 % )、短暂性停经 4 / 2 7(14 .8% )、闭经 2 / 2 7(7.4 % ) .结论子宫动脉栓塞术治疗子宫肌瘤安全、有效、损伤小 .但栓塞前需行活检术排除恶性病变 .

Objective To study the clinical effects and complications of uterine artery embolization for uterine fibroids. Methods Uterine artery embolization was performed in 27 patients. All cases were diagnosed as uterine fibroids with pathological examination by biopsy. The changes of uterus size,fibroids size,clinical symptoms and complications were followed up in 3～18 months after procedure. Results There were 25 patients out of 27 (92.6%) who had satisfying clinical results. The menorrhagia ceased in 17 patients (89.5%, 17/19). The dysmenorrhea was improved in 8 patients (88.9%, 8/9). The volume of uterus decreased 48.9± 15.6 % (t=13.3921,p<0.001).The shrinkage of the fibroids was 56.8±17.9%(t=14.6403,p<0.001)in volume. The complications included mild-moderate fever in 20 patients out of 27(74.1%);moderate-severe pelvic cramp in 5 patients(18.5%);shortened inter-menstrual period in 10 patients(37.0%);temporary amenorrhea in 4 patients (14.8%);permanence amenorrhea in 2 patients(7.4%). Conclusions Uterine artery embolization is a safe, effective , micro-trauma therapy for uterine fibroids. But percutaneouse biopsy is recommended before the operation for ruling out the malignant disease in uterus.