子宫动脉栓塞治疗子宫肌瘤和子宫腺肌症(附24例报告)

Treatment of uterine fibroid and adenomyoma by uterine arterial embolization:Report of 24 cases

目的 评价子宫动脉栓塞 (uterinearterialembolization ,UAE)治疗子宫平滑肌瘤和子宫腺肌症的疗效。 方法 2 2例子宫肌瘤和 2例子宫腺肌症行双侧子宫动脉栓塞 2 3例 ,单侧 1例 ,栓塞剂为PVA微球。 结果 子宫动脉栓塞成功率为95 8% (2 3/2 4 ) ,未发生严重并发症。术后 6个月子宫体积及肌瘤体积与栓塞前比较均显著缩小 (t=2 391,3 990 ;P =0 0 2 2 ,0 0 0 0 )。 1例子宫动脉单侧栓塞术后肌瘤逐渐长大 ,行子宫切除术。 2例子宫腺肌症术后痛经、月经过多症状减轻 ,但术后 4个月复发。 结论 UAE治疗子宫肌瘤微创 ,安全 ,疗效满意 ,但远期疗效尚待观察。对子宫腺肌症疗效不满意。

Objective To evaluate the effectiveness of uterine arterial embolization (UAE) in the management of uterine fibroids (UF) and adenomyoma. Methods The UAE was carried out in 22 cases of UF and 2 cases of adenomyoma, including bilateral UAE in 23 cases and unilateral UAE in 1 case, by using polyvinyl alcohol (PVA) particles as embolic materials. Results The success rate of UAE in the study was 95 8% (23/24). No serious complications occurred. The uterine and UF volume decreased remarkably in size 6 months after the treatment ( t =2 391 and 3 990, respectively; P =0 022 and 0.000, respectively). In the patient who underwent unilateral UAE, the UF gradually increased in size and a hysterectomy was required. The 2 patients with adenomyoma experienced relief with this treatment but had a recurrence 4 months after the surgery. Conclusions UAE is a safe and effective method in the management of UF but its long-term effects remains a question to be answered through further observations . The efficacy of treatment of this method for adenomyoma is not apparent.