摘要
目的 探讨经导管子宫动脉栓塞 (TUAE)治疗子宫肌瘤的疗效及安全性。方法 对 38例子宫肌瘤患者经导管子宫动脉注射碘油 平阳霉素乳剂行TUAE治疗 ,其中 5例于栓塞后 1～ 3周行全子宫切除或肌瘤剔除术 ,标本送病理检查 ;对 33例随访 6～ 12个月者 ,观察肌瘤与子宫体积变化及卵巢内分泌功能改变。结果 行TUAE后 ,患者总的症状改善率为 90 6 % (2 9/ 32 ) ,其中月经完全恢复正常为 90 3% (2 8/ 31) ,下腹部、腰腿胀痛消失为 83 3% (2 5 / 30 ) ,尿频、尿急等压迫症状消失为45 5 % (5 / 11)。栓塞 6个月后 ,肌瘤与子宫体积平均缩小为 5 9 1%和 49 3% ,栓塞 12个月后平均缩小为 6 1 8%和 49 9%。卵巢内分泌功能栓塞前后无显著变化。手术标本病理学检查 ,碘油仅分布于肌瘤组织 ,栓塞 2周后肌瘤组织出现点状坏死 ,3周后出现大量片状坏死 ,而正常子宫肌组织未见异常。结论 行TAUE治疗子宫肌瘤 ,近期疗效明显 。
Objective To investigate the efficiency and safety of transcatheter uterine artery embolization (TUAE) for uterine myomas. Methods Thirty-eight cases of uterine myomas were treated by TUAE using lipiodol-pingyangmycin emulsion. 5 of 38 cases underwent hysterectomy or myomectomy from 1 to 3 weeks after TUAE. The specimens were studied pathologically. Thirty-three of 38 patients were followed for 3 to 6 months to observe the changes of myoma size and uterine volume and overian function. Results Symptom released in 90.6% (29/32), that was controlled of menorrhagia in 90.3% (28/31), disappeared of lumbago and lower abdominal pain in 83.3% (25/30), relieved of freguency and urgency of micturition in 45.5% (5/11). The mean reduction of myoma and uterine volume at 6 months was 59.1% and 49.3%, respectively, and at 12 months was 61.8% and 49.9% respectively. There was no significant difference in hormone level pre-embolization and post-embolization. Pathological studies of specimens showed that lipiodol deposition was found in myomas but not in myometrium. Myomas occurred spotty necrosis 2 weeks after embolization and extensive patchy necrosis 3 weeks after embolization. Degeneration or necrosis were not seen in myometrium. Conclusions TUAE possesses a good effect for uterine myomas and doesn′t result in the damage of ovarian hormone secretion and the myometrium.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2002年第1期12-15,共4页
Chinese Journal of Obstetrics and Gynecology
关键词
子宫肿瘤
平滑肌瘤
治疗性栓塞
Uterine neoplasms
Leiomyoma
Embolization, therapeutic
