不同子宫动脉介入栓塞材料治疗子宫肌瘤的临床疗效及对子宫血供和卵巢功能的影响

Effect of different uterine artery interventional embolization on uterine fibroids and its influence on uterine blood supply and ovarian function

目的探讨子宫肌瘤治疗中不同子宫动脉介入栓塞(UAE)材料的临床疗效及对子宫血供和卵巢功能的影响。方法回顾性选取2021年2月至2023年2月衡水市哈励逊国际和平医院收治的子宫肌瘤患者80例,依据不同UAE材料分为聚乙烯醇(PVA)组、平阳霉素碘化油乳剂(PLE)组,每组各40例。对比观察两组患者的子宫肌瘤体积、子宫体积、心理状态、生活质量[生存质量测定量表简表(QOL-BREF)评分]、实验室指标[血红蛋白、肿瘤特异性生长因子(TSGF)、胰岛素样生长因子-1(IGF-1)]、子宫血供[最粗供血动脉管径、收缩期峰值血流速度(Vs)、平均流速(Vm)、阻力指数]、卵巢功能[促黄体生成素(LH)、促卵泡生成素(FSH)、孕酮、雌二醇]、临床疗效、术后综合征发生情况、复发情况。结果治疗后,两组患者的子宫肌瘤体积、子宫体积、焦虑评分、抑郁评分、QOL-BREF评分、血红蛋白、TSGF、IGF-1、最粗供血动脉管径、Vs、Vm、阻力指数、LH、FSH、P、E2水平之间的差异均无统计学意义(P>0.05)。PVA组与PLE组患者的治疗总有效率(92.50%vs.90.00%)比较,差异无统计学意义(P>0.05)。PVA组患者的术后综合征发生率为35.00%,明显低于PLE组(62.50%),差异有统计学意义(P<0.05)。PVA组患者的复发率为0,明显低于PLE组(15.00%),差异有统计学意义(P<0.05)。结论子宫肌瘤治疗中采用PVA和PLE进行UAE治疗的临床疗效相当,对子宫血供的影响相当,均不会对卵巢功能造成影响。栓塞剂选择PVA术后综合征总发生率和复发率低于PLE。

Objective To explore the clinical efficacy of different uterine artery embolization(UAE)materials in the treatment of uterine fibroids and their impact on uterine blood supply and ovarian function.Methods A retrospective selection was conducted on 80 patients with uterine fibroids who were admitted to Hengshui Harison International Peace Hospital from February 2021 to February 2023.They were divided into two groups based on different UAE materials:polyvinyl alcohol(PVA)group and pingyangmycin iodized oil emulsion(PLE)group,with 40 cases in each group.The volume of uterine fibroids,uterine volume,psychological status,quality of lifequality of life brief scale(QOL-BREF)score,laboratory indicators[hemoglobin,tumor specific growth factor(TSGF),insulin like growth factor-1(IGF-1)],uterine blood supply[diameter of the thickest supplying artery,systolic velocity(Vs),average velocity(Vm),resistance index],ovarian function[luteinizing hormone(LH),follicle stimulating hormone(FSH),progesterone,estradiol],clinical efficacy,incidence of postoperative syndrome,and recurrence between two groups of patients were compared and observed.Results There were no statistically significant differences in the volume of uterine fibroids,uterine volume,anxiety score,depression score,QOL-BREF score,hemoglobin,TSGF,IGF-1,diameter of the thickest supplying artery,Vs,Vm,RI,LH,FSH,progesterone,and estradiol levels between the two groups of patients(P>0.05).There was no statistically significant difference in the total effective rate between the PVA group and the PLE group(92.50%vs.90.00%)(P>0.05).The incidence of postoperative syndrome in the PVA group patients was 35.00%,which was significantly lower than that in the PLE group patients(62.50%),and the difference was statistically significant(P<0.05).The recurrence rate of patients in the PVA group was 0,which was significantly lower than that in the PLE group(15.00%),and the difference was statistically significant(P<0.05).Conclusion The clinical efficacy of using PVA and PLE for UAE treatment in the treatment of uterine fibroids is comparable,with a similar impact on uterine blood supply and no impact on ovarian function.The overall incidence and recurrence rate of PVA postoperative syndrome are lower than those of PLE when choosing embolic agents.