子宫动脉栓塞术治疗子宫肌瘤的不良反应

No Fine Reaction in Uterine Myomata by Arterial Embolization

目的 探讨子宫动脉栓塞术(UAE)治疗子宫肌瘤的副反应及并发症发生的原因和防治措施。方法 30例患者,用平阳霉素碘油乳剂(PIE)或聚乙烯醇(PVA)微粒加明胶海绵栓塞双侧子宫动脉,阻断肌瘤血供。结果UAE后全部患者发生栓塞后综合征,其中膀胱刺激症状发病率为16.7％(5/30),阴道出血为63.3％(19/30),闭经为3.3％(1/30),阴道排液为(3/30),麻痹性肠梗阻为3.3％(1/30),下肢跛行为3.3％(1/30),尿路感染为3.3％(1/30)。所有副反应经对症处理后消失,绝大部分并发症经治疗后恢复。结论 UAE后可能出现副反应及并发症,严格掌握适应证,准确栓塞靶血管是提高疗效和避免并发症发生的关键。对UAE后患者出现闭经的原因还需作进一步深入研究。

Objective To evaluate the clinical reason and therapy of side effects and complications in uterine myomata treated by uterine arterial embolization(UAE). Methods 30 cases of uterine myomata were treated by pingyangmycin - li-piodol emulsion or polyvinyl alcohol(PVA) -gelatin sponge in bilateral uterine arteries. Results The postembolization syndrome were 100% (30/30). The frequency and urgency of micturition occurred in 16. 7% (5/30), vagina hemorrhage in 63. 3% (19/30), vagina secretion in 10% (3/30), menopause, intestinal obstruction, lower limb lame and urinary tract infections in 3. 3(1/30) respectively. Conclusion Some serious side effects and complications may occurred in UAE. We should firmly master the indication and selectively inserted an artery catheter into bilateral uterine arteries.