子宫动脉栓塞治疗子宫肌瘤(附17例临床分析)

Clinical Analysis of Transcatheter Uterine Arterial Embolization for the Treatment of Uterine Leiomyoma

目的 探讨经导管子宫动脉栓塞术 (TUAE)治疗子宫肌瘤技术的方法 ,并评价其临床疗效。材料与方法 用直径为 35 0～ 5 0 0 μm的聚乙烯醇微粒 (PVA)及自制 1mm左右的明胶海绵颗粒对 17例诊断明确的子宫肌瘤进行双侧子宫动脉栓塞 ,术后观察子宫体积及肌瘤体积的变化 ,月经量及月经周期 ,临床症状改善情况。结果 术后随访 6～ 12个月 ,术前子宫平均体积 4 35 18cm3 ,术后为 2 2 2 5 1cm3 ,缩小 4 8 87% (P <0 0 1) ,术前肌瘤平均体积 10 2 4 7cm3 ,术后为 5 2 10cm3 ,缩小 4 9 16% (P <0 0 1) ,所有病例临床症状都得到缓解 ,彩超检查子宫肌层及病灶内血流信号明显减少。总有效率 88 2 %。无严重并发症发生。结论 TUAE能有效地消除临床症状 ,缩小肿瘤体积 ,是一种较好的治疗手段 。

Objective To investigate the technique and the effect of transcatheter uterine arterial embolization (TUAE) for treatment of uterine leiomyoma. Methods Bilateral uterine arterial embolization was performed in 17 cases of uterine leiomyoma. The embolic materials were polyvinyl alcohol (PVA) particles with diameter 350um and gelfoam. After TUAE menstrual periods, volume of uterine and its myoma, clinical symptoms were observed. Results The follow-up of 6～12 months showed that there was significant difference of the average volume of the uterus and its myoma between preoperation and postoperation (435.18cm vs 222.15cm, 102.47cm vs 52.10 cm, respectively P<0.01). All clinical symptoms of 17 cases released. Color Doppler detected that the blood flow within the uterine and lesion significantly decreased immediately after TUAE. The total effectiveness was 88.2%. Conclusion TUAE might be effective to relieve the clinical symptoms and to reduce the leiomyoma volume. It could a good method to be accepted by the patient.