对比微波消融、子宫动脉栓塞治疗单发子宫肌壁间肌瘤效果

Comparison on effect of microwave ablation and uterine artery embolization for treatment of single intramural uterine leiomyoma

目的对比观察微波消融(MWA)与子宫动脉栓塞(UAE)治疗单发子宫肌壁间肌瘤的临床效果。方法回顾性分析49例单发子宫肌壁间肌瘤患者,27例接受MWA治疗(MWA组),22例UAE治疗(UAE组),比较2组治疗效果及预后。结果2组术后月经过多、痛经、贫血等症状均缓解并逐渐消失。术后均出现发热、腹痛及阴道排液等并发症,经对症处理或未经处理自行恢复。术后随访12个月,术后3、6个月MWA组肌瘤体积及最大径均小于UAE组(P均<0.05)。术后6、12个月MWA组血清卵泡刺激素(FSH)、黄体生成素(LH)水平均低于UAE组(P均<0.05),雌二醇(E2)水平高于UAE组(P<0.05)。MWA组复发率为25.93%(7/27),UAE组为27.27%(6/22),差异无统计学意义(P>0.05)。结论MWA和UAE治疗单发子宫肌壁间肌瘤疗效确切、安全可靠,MWA效果优于UAE。

Objective To compare the effect of microwave ablation(MWA)and uterine artery embolization(UAE)for treatment of single intramural uterine leiomyoma.Methods Data of 49 patients with single intramural uterine leiomyoma were retrospectively analyzed,including 27 cases received MWA(MWA group)and underwent UAE(UAE group).The therapeutic effect and prognosis were compared between 2 groups.Results After treatment,menorrhagia,dysmenorrhea,anemia and other symptoms relieved and gradually disappeared in both groups.Complications,such as fever,abdominal pain and vaginal discharge were found but cured after symptomatic treatment or without treatment.The volume and maximum diameter of uterine leiomyoma in MWA group were less than those in UAE group 3 and 6 months after therapy(all P<0.05).The levels of follicle-stimulating hormone(FSH)and luteinizing hormone(LH)in MWA group were lower than those in UAE group,but the level of estradiol(E2)in MWA group was higher than UAE group 6 and 12 months after therapy(all P<0.05).During 12 months'following-up,the recurrence rate of uterine leiomyoma was 25.93%(7/27)in MWA group and 27.27%(6/22)in UAE group(P>0.05).Conclusion Both MWA and UAE are effective and safe for treatment of single intramural uterine leiomyoma,and the former has better effect.