子宫肌瘤栓塞治疗操作技术及相关因素分析

Analysis of technique and related factors of uterine artery embolization of leiomyomas

目的 :对子宫肌瘤动脉栓塞治疗的操作技术及相关因素进行分析 ,以提高技术成功率 ,减少并发症和X线辐射。方法 :对 10 6例行子宫肌瘤动脉栓塞治疗的患者进行回顾性分析 ,比较不同设备和技术条件下的技术成功率 ,并比较用不同投照角度造影对子宫动脉的显示情况。结果 :早期在旧设备下治疗的 2 1例患者 ,有 2支子宫动脉插管未成功。后在新设备下治疗 85例 ,全部子宫动脉插管成功。正位造影子宫动脉显示满意和比较满意的占 9.0 %和 2 4.0 %,右倾斜和左倾斜 3 0°～ 40°造影分别为 5 4.0 %和 2 9.9%,两者差异有显著性意义。结论 :要安全、快捷地进行子宫肌瘤动脉栓塞治疗 ,良好的操作技术和设备条件是基础。为清楚显示子宫动脉起始处以指导插管 ,取左和右倾斜造影 3 0°～ 40°较正位要好。

Objective:To analyze the key technical points and related factors of uterine artery embolization (UAE) for leiomyomas in order to improve successful manipulation and decrease the complication and dosage of radiation. Methods: 106 cases of uterine leiomyoma undergoing UAE were retrospectively analyzed.A comparative study was made between the success rates of the procedures under the conditions of different facilities and techniques.The visualizations of uterine artery were compared with different projecting positions.Results:2 of 21 cases were not successfully catheterized on older equipment,but catheterization of all 85 cases was successful on modern equipment.The rate of satisfactory or relative satisfactory visualization in P A projection was respectively 9.0% and 24.0%,while in right and left oblique ( 30°～ 40°) projection the rate was 54.0% and 29.9%,respectively.There was significant difference between P A and oblique projections.Conclusion:The performance of a safe and quick UAE requires the state of the art angiographic facility,and experienced operator.The right and left oblique (30°～40°) position is better than P A position in displaying uterine arteries.