动脉栓塞术治疗子宫肌瘤及肌腺瘤临床研究136例

Embolism treatment of hysteromyoma and adenomyoma

目的 :研究子宫动脉栓塞术治疗子宫肌瘤及子宫肌腺瘤的方法 ,疗效和结果。探讨其可能成为子宫肌瘤及子宫肌腺瘤的支柱疗法之一。材料与方法 :本组 136例患者 ,子宫肌瘤患者 12 5例 ,肌腺瘤患者 11例。其中 ,瘤体最大为 18.6× 17.8cm ,最小为 3.1× 3.5cm ,血红蛋白最低仅为 31g/L。月经过多、贫血、痛经、经期大小便异常、腰酸及下腹部下坠感等症状严重者 71例。有生育要求者 9例。合并高血压者 5例 ,合并肝功能异常者 6例。对所有病例行股动脉穿刺 ,肌瘤供血动脉插管和栓塞。结果 :操作成功率为 98.5 %。术后 1～ 6个月复查 ,患者的瘤体均有明显缩小 ,平均缩小为原来的4 6 .5 %。目前缩小最多的为栓塞前的 1.5 %。腹痛和经量增多等症状基本缓解。治疗总有效率为 97.8%。未发现严重并发症。结论 :子宫肌瘤栓塞治疗安全有效 ;创伤微小 ,适应征宽 ;并发症和后遗症少 ;保留生育功能 ,又不影响性生活和生活质量 ,可以成为一个很有前途的治疗方法。

Objective: We intended to probe the way of uterine artery embolism to treat hysteromyoma and adenomyoma, and evaluate the therapeutic effectiveness and result. Maybe it will be one of supporting treatments of hysteromyoma and adenomyoma. Materials and Method: There were 136 patients. 125 cases were hysteromyoma, 11 cases were adenomyoma. The biggest myoma was 18.6×17.8cm, the smallest was 3.1×3.5cm,the lowest of hemoglobinemia was only 31g/L. 71 cases had hypermenorrhea, anemia, dysmenorrhea, menstrual abnormal stool and urine, lumbago and hypogastralgia. 9 cases had need of fertility. 5 cases had complication of hypertension. 6 cases had complication of abnormal hepatic function. In all cases, we punctured femoral artery, tubed two supplying arteries of uterine, and embolized them. Result: The rate of success was 98.5%. Callbacking after 1～6 months, myomaes shrunk obviously, the volume were 46.5% of before ones averagely. The abdomen ache and dysmenorrhea were released. The total effective rate was 97.8%. And no serious complication had. Conclusion: The embolism treatment of hysteromyoma was safe and effective with small wound, wide indication, small amount of complication and sequelae. It can reserve the fertility, and doesn't affect sexual life and quality of life. It can be a progressive treatment.