双侧子宫动脉栓塞术治疗育龄期子宫肌瘤疗效观察.docVIP

双侧子宫动脉栓塞术治疗育龄期子宫肌瘤疗效观察作者单位：611130 成都市温江区中医院通讯作者：宋世强 【摘要】目的探讨双侧子宫动脉栓塞术（BUAE）治疗育龄期子宫肌瘤的临床价值。方法对41例育龄期子宫肌瘤患者，选择平阳霉素乳剂(PLE)+明胶海绵颗粒(GS)行BUAE治疗。术后3个月、6个月、12个月随访，观察疗效及并发症。结果BUAE术后全部患者临床症状缓解，38例(92?7%)患者月经恢复正常。术后3个月、6个月、12个月复查，肌瘤缩小率分别为34?8%、55?1%、74?9%。结论BUAE能有效地缩小肌瘤体积，并明显改善临床症状，是一种疗效显著的微创技术，对于育龄期子宫肌瘤患者的治疗有重要价值。【关键词】育龄期；子宫肌瘤；双侧；子宫动脉栓塞术；治疗 Clinical effect of bilateral uterine artery embolization in treatment of reproductive-aged women with fibroidSONG Shi-qiang.Wenjiang hospital of traditional Chinese medicine,Chengdu 611130,China【Abstract】ObjectiveTo explore the clinical value of bilateral uterine artery embolization(BUAE)in treatment of reproductive-aged women with fibroid.Methods41 reproductive-aged women with fibroid were treated with PLE+gelatin sponge particles(GS).3 months,6 months,12 months later,the clinical effect and complications were assessed.ResultsAfter BUAE,all patients?clinical symptoms were controled,38 patients(92?7%)returned to normal menstruation.3 months,6 months,12 months later,fibroid shrink rates were 34?8%,55?1%,74?9% respectively.ConclusionBUAE can reduce the volume of fibroid and significantly improve clinical symptoms,it is a significant wiresoft technique and has significant value in treatment of reproductive-aged women with fibroid.【Key words】Reproductive age;Fibroid;Bilateral;Uterine artery embolization;Treatmentdoi:10.3969/j.issn.1674-4985.2012.01.079子宫肌瘤在育龄期妇女发病率约20%～25%，严重影响妇女身心健康［1］。子宫切除为目前子宫肌瘤的常用治疗手段，但对于育龄期妇女要考虑其生育的权利。介入放射学的发展为子宫肌瘤的治疗开辟了新的途径。双侧子宫动脉栓塞术（bilateral uterine artery embolization，BUAE）不仅可治愈子宫肌瘤，同时还能保留子宫，尤其适合于育龄期女性子宫肌瘤患者的治疗。笔者所在医院采用BUAE治疗子宫肌瘤41例，获得显著的临床疗效，现报道如下。1资料与方法 1?1一般资料选择2007年5月～2010年5月子宫肌瘤患者41例，年龄23～39岁，均已婚。术前均经妇科医师、B超或MRI检查确诊为子宫肌瘤（其中8例为单发子宫肌瘤，33例为多发子宫肌瘤；3例黏膜下子宫肌瘤，38例肌壁间子宫肌瘤）。肌瘤直径3～7 cm。37例经量增多，21例伴经期延长，下腹部疼痛31例 1?2治疗方法术前行常规检查，禁饮食4 h，排空膀胱，备皮，仰卧位，取右侧股动脉为介入穿刺点。利多卡因局麻后穿刺，插入导管、导丝、超选择进入双侧子宫动脉，注入造影剂，见子宫动脉输卵管支迂曲增粗，肌瘤血管网纵横交错，为手抱球状或不规则形，注入平阳霉素加碘化油混合乳剂（平阳霉素8～24 mg，碘化油5～15 ml），见肌瘤内沉积良好、血流明显变慢后，用新鲜明胶海绵颗粒(直径1～3 mm)栓塞子宫动脉主干。介入