子宫动脉栓塞术对子宫肌瘤患者血流动力学 内分泌功能及再次妊娠的影响

Effect of uterine artery embolization on hemodynamics,endocrine function,and re-pregnancy in patients with uterine fibroids

目的探讨子宫动脉栓塞术对子宫肌瘤患者血流动力学、内分泌功能及再次妊娠的影响。方法选择2016年3月-2018年7月宁波大学医学院附属医院妇科接诊子宫肌瘤患者76例均给予子宫动脉栓塞术治疗,术后随访12个月,观察患者手术前、后血流动力学、内分泌功能、子宫体积、子宫肌瘤体积变化及再次妊娠率情况。结果术后1、3个月子宫肌瘤患者的血流动力学指标PI、RI值较术前增高,但SPV、EDV值较术前降低,差异有统计学意义(P<0.05)。子宫肌瘤患者术后3、6、12个月的内分泌功能指标P、E2、FSH表达水平和术前对比差异无统计学意义(P>0.05)。子宫肌瘤患者术后1、3个月的子宫体积、子宫肌瘤体积均低于术前,差异有统计学意义(P<0.05)。随访12个月发现,76例子宫肌瘤患者经子宫动脉栓塞术治疗后再次妊娠27例,再次妊娠率为35.53%。结论子宫动脉栓塞术对子宫肌瘤患者血流动力学的影响较大,但对患者内分泌功能基本无影响,可有效改善病情,促进子宫肌瘤萎缩或消失,使患者正常妊娠功能恢复,值得推广。

Objective To explore the effect of uterine artery embolization on hemodynamics,endocrine function,and re-pregnancy in patients with uterine fibroids.Methods From March 2016 to July 2018,76 patients with uterine fibroids underwent uterine artery embolization in Department of Gynecology,Affiliated Hospital of Medical College,Ningbo University,then the patients were followed up for12 months.The hemodynamics,endocrine function,uterine volumes,uterine fibroid volume change before and after surgery,and re-pregnancy rate were observed.Results At one and three months after surgery,PI and RI in patients with uterine fibroids were higher than those before surgery,while SPV and EDV were lower than those before surgery,there were statistically significant differences(P<0.05).There was no statistically significant difference in the levels of P,E2,and FSH between before surgery and at 3,6,12 months after surgery(P>0.05).At one and three months after surgery,uterine volume and uterine fibroid volume were statistically significantly lower than those before surgery(P<0.05).After 12 months of follow-up,27 patients got pregnancy,the re-pregnancy rate was 35.53%.Conclusion The effect of uterine artery embolization on hemodynamics in patients with uterine fibroids is great,but it has no impact on endocrine function,uterine artery embolization can effectively improve the condition,promote atrophy or disappearance of uterine fibroids,and restore normal pregnancy function of patients,which is worthy of promotion.