子宫动脉栓塞术与肌瘤剔除术治疗子宫肌瘤的临床疗效对比分析

For the Treatment of Uterine Artery Embolization with Myoma Eliminating Compared the Clinical Effect of the Treatment of Uterine Fibroids

目的:全面评估子宫动脉栓塞的治疗效果,为临床开展和推广介入栓塞技术提供有利的依据。方法:将2015年1月至2016年6月收住的60例子宫肌瘤患者随机分为观察组和对照组,每组各30例。观察组采用子宫动脉栓塞术(UAE),应用Seldinger’s法经皮股动脉穿刺,通过动脉导管推入聚乙烯醇微粒,阻断瘤体血供;对照组行常规妇科子宫肌瘤剔除术。观察两组患者术后治疗效果。结果:(1)6个月之内对所有患者进行随访,两组患者手术前后临床症状(经期时间、月经量、贫血、痛经、尿频和排尿困难)比较,差异无统计学意义(P>0.05);(2)两组患者副反应和并发症发生率比较(疼痛、发热、呕吐、阴道排液)差异无统计学意义(P>0.05);(3)观察组术后肌瘤明显缩小,术前、术后血FSH、LH及E2水平变化无统计学意义(P>0.05);(4)两组患者相比,观察组患者手术时间缩短,差异有统计学意义(P<0.05);术后随访肌瘤复发率无差异(P>0.05)。结论:子宫动脉栓塞术治疗子宫肌瘤临床效果好,安全性高,对患者创伤小,具有临床推广的意义。

Objective：To evaluate the therapeutic effect of uterine artery embolization, and to provide a favorable basis for clinical development and clinical application of interventional embolization technique.Methods： 60 cases of uterine fibroids were randomly divided into observation group and control group from June 2016 to January2015,with 30 cases in each group.The observation group,using Seldinger s method of percutaneous femoral artery puncture,polyvinyl alcohol particles into the tumor through a catheter,blocking the blood supply,to observe the effect of treatment for all patients;the control group underwent routine gynecological myomectomy. Observation of two groups of patients after the treatment effect.R esults：（1）within 6 months of follow-up in two groups,the clinical symptoms of patients before and after surgery（menstrual time,menstruation,anemia,dysmenorrhea,frequent urination and dysuria）,the difference was not statistically significant（P〉0.05）;（2）comparison of the incidence of two groups of patients with adverse reactions and complications（pain,fever,vomiting,vaginal discharge） showed no significant difference（P 〉0.05）.（3）in observation group,the postoperative myoma was significantly reduced,and the changes of FSH,LH and E2 levels were not statistically significant（P〉0.05） before and after operation.（4）compared two groups of patients,patients in the observation group the operative time is shorter,the difference was statistically significant（P〈0.05）;postoperative follow-up the recurrence rate had no difference（P〉 0.05）.Conclusions：The clinical effect of uterine leiomyoma is good,small trauma,high safety,has clinical significance.