UAE治疗症状性肌壁间子宫肌瘤的临床观察

Clinical Observation of UAE in Treatment of Symptomatic Uterine Fibroids

目的:探讨症状性肌壁间子宫肌瘤经子宫动脉栓塞术治疗的临床效果及安全性。方法:选取本院2013年8月-2015年10月收治的症状性肌壁间子宫肌瘤患者45例,均经皮穿刺右侧股动脉,插入导管后使用博来霉素碘化油乳剂进行双侧子宫动脉栓塞。收集患者术前和术后第3、6个月的FSH、LH、E2、血红蛋白水平与肌瘤体积等数据,进行对比分析。结果:45例患者均成功行双侧子宫动脉栓塞术。31例患者术后有短暂低热,23例患者出现不同程度恶心、呕吐等消化道症状,19例患者出现下腹坠胀、腰骶酸痛症状,对症治疗后均缓解。术后第3个月,患者FSH较术前升高,LH与E2均较术前降低,而血红蛋白和肌瘤体积均较术前有所改善,差异均有统计学意义(P<0.05)。术后第6个月,患者FSH、LH与E_2恢复至术前水平,血红蛋白和肌瘤体积较术后第3个月持续改善(P<0.05)。结论:症状性肌壁间子宫肌瘤经子宫动脉栓塞术治疗后,虽在短期内会影响卵巢功能,但能够显著缩小肌瘤体积,改善贫血,且无严重并发症,疗效值得临床肯定。

Objective：To investigate the clinical efficacy and safety of uterine artery embolization（UAE） in the treatment of symptomatic uterine fibroids.Method：45 cases of symptomatic uterine fibroids in our hospital from August 2013 to October 2015 were selected,percutaneous puncture right femoral artery,used bleomycin iodized oil emulsion for bilateral uterine artery embolization after inserted the catheter.The data of FSH,LH,E2,hemoglobin level and myoma volume were collected before and after 3,6 months of operation,and the data were compared and analyzed.Result：45 patients underwent bilateral uterine artery embolization successfully.31 patients had transient low fever,23 cases with varying degrees of nausea,vomiting and other gastrointestinal symptoms,19 cases with abdominal distension,waist and sacral pain symptoms,all symptoms were relieved after specific treatment.At third months after operation,the patients＇ FSH was higher than that before operation,and LH and E2 were decreased,and hemoglobin and myoma volume were improved,the differences were statistically significant（P〈0.05）.At the sixth months after surgery,patients with FSH,LH and E_2 recovered to preoperative levels,whereas hemoglobin and myoma volume continued to improve after the third months（ P〈0.05）.Conclusion：Symptomatic uterine fibroids uterine artery use embolization treatment,although will affect ovarian function in the short term,but it can significantly reduce the size of the myoma,relieve anemia,and no serious complications,curative effect is worthy of clinical affirmation.