超选择性子宫动脉栓塞治疗子宫肌瘤安全性及有效性分析

Safety and effectiveness of superselective embolization of the uterine arteries in the treatment of uterine fibroids

目的分析超选择性子宫动脉栓塞治疗子宫肌瘤的安全性及有效性。方法回顾性分析浙江省荣军医院2020年2月至2022年2月收治的子宫肌瘤患者60例的临床资料,根据手术方式不同分为对照组和观察组,每组30例。对照组行常规外科手术,观察组实施超选择性子宫动脉栓塞治疗,比较两组患者子宫与肌瘤大小变化情况、术后激素水平、并发症发生情况。结果观察组总有效率[93.33%(28/30)]与对照组[83.33%(25/30)]比较,差异无统计学意义(χ^(2)=1.46,P>0.05)。术后,观察组血清雌二醇[(164.14±19.97)ng/L]、促黄体生成素[(2.43±1.47)IU/L]、卵泡刺激素[(2.51±1.14)IU/L]、孕酮[(5.05±0.43)μg/L]水平均显著低于对照组[(190.23±21.62)ng/L、(3.78±1.63)IU/L、(3.94±1.23)IU/L、(8.22±1.35)μg/L](t=4.86、3.37、4.67、12.25,均P<0.001);观察组术后并发症发生率[3.33%(1/30)]低于对照组[20.00%(6/30)](χ^(2)=4.04,P<0.05)。结论超选择性子宫动脉栓塞治疗子宫肌瘤相较于常规外科手术不仅疗效显著,还能保持术后激素水平稳定,减轻或避免近、远期并发症发生,值得推广。

Objective To analyze the safety and effectiveness of superselective embolization of the uterine arteries in the treatment of uterine fibroids.Methods The clinical data of 60 patients with uterine fibroids who were admitted to Zhejiang Veteran Hospital from February 2020 to February 2022 were retrospectively analyzed.These patients were divided into a control group and an observation group(n=30/group)according to different surgical methods.The control group underwent conventional surgery.The observation group underwent superselective embolization of the uterine arteries.Uterine size,uterine fibroid size,postoperative hormone level,and complications were compared between the two groups.Results There was no significant difference in total response rate between the observation and control groups[93.33(28/30)vs.83.33(25/30),χ^(2)=1.46,P>0.05].After surgery,serum estradiol,luteinizing hormone,follicle-stimulating hormone,and progesterone levels in the observation group were(164.14±19.97)ng/L,(2.43±1.47)IU/L,(2.51±1.14)IU/L,and(5.05±0.43)μg/L,respectively,which were significantly lower than(190.23±21.62)ng/L,(3.78±1.63)IU/L,(3.94±1.23)IU/L,(8.22±1.35)μg/L in the control group(t=4.86,3.37,4.67,12.25,all P<0.05).The incidence of postoperative complications in the observation group was significantly lower than that in the control group[3.33%(1/30)vs.20.00%(6/30),χ^(2)=4.04,P<0.05).Conclusion Compared with conventional surgery,superselective embolization of the uterine arteries is more effective on uterine fibroids,better keep postoperative hormone level stable,and reduce or avoid short-and long-term complications.Therefore,superselective embolization of the uterine arteries for the treatment of uterine fibroids deserves the clinical promotion.