经导管子宫动脉栓塞对卵巢功能及正常子宫肌组织的影响

Influence of Transcatheter Uterine Artery Embolization on Ovarian Function and Myometrium

目的 探讨经导管子宫动脉栓塞 (TUAE)对卵巢功能与正常子宫肌组织的影响及意义。资料与方法 10 1例子宫肌瘤与 2 5例子宫腺肌病患者行经导管子宫动脉注射碘油平阳霉素乳剂 (LPE)加明胶海绵颗粒栓塞治疗。通过栓塞后月经观察、卵巢内分泌功能测试、MR检查、经前诊刮及栓塞后全子宫切除标本病理研究 ,了解栓塞后卵巢功能及正常子宫肌组织的改变。结果 月经观察无闭经发生 ,经前诊刮病理提示子宫内膜呈分泌期改变。卵巢内分泌功能测试栓塞前后变化无明显差异 (P >0 .0 5 )。MR检查正常子宫肌层未见缺血改变 ,切除标本病理观察正常子宫肌组织亦未见坏死发生。结论 TUAE是一项安全的治疗技术 。

Objective To investigate the influence of transcatheter uterine artery embolization (TUAE) on ovarian function and myometrium and its clinical significance.Materials and Methods Using Lipiodol-pingyangmycin emulsion and Gelfoam particles, TUAE was performed in 101 patients with uterine fibroids and 25 patients with adenomyomas. After TUAE, ovarian function and myometrium were estimated by observing menstruation, ovarian hormones level, MRI and the pathological results of premenstrual diagnostic curettage and resected specimens.Results No amenorrhea occurred during the period of observation. Pathologically, premenstrual diagnostic curettage showed that endometrium took the form of secretory stage. No significant difference in ovarian hormones level between pre- and post-embolization (P>0.05) was seen. Neither ischemia on MRI nor pathological necrosis in the resected specimens was seen in myometrium.Conclusion TUAE is a quite safe therapeutic procedure, which has no adverse effect on the ovarian function and the normal myometrium.