子宫动脉栓塞术治疗子宫肌瘤的临床应用  

Uterine artery embolization therapy for treatment of uterine myoma

作　　者：吴乾渝[1] 李茂全[2] 徐瑾[1] 洪孚卿[1] 焦菊芳[1] 陈子君[1] 

机构地区：[1]同济大学附属东方医院妇产科,上海200120 [2]同济大学附属东方医院介入放射中心,上海200120

出　　处：《上海医学》2004年第11期843-845,F003,共4页Shanghai Medical Journal

基　　金：上海市卫生局青年基金资助项目 ( 99Y2 0 )

摘　　要：目的　探讨子宫动脉栓塞术 (UAE)用于治疗子宫肌瘤的方法、效果及围术期管理。方法　采用同轴导管经股动脉穿刺插管到子宫动脉 ,注入聚乙烯醇微球 (PVA)栓塞子宫动脉。结果　 1999～ 2 0 0 2年对 4 2例子宫肌瘤患者施行UAE ,围术期并发症包括阴道流血、腹痛、发热 ,经对症治疗后均得到有效控制 ,无严重并发症。随访半年和 1年后症状明显改善的患者分别占 74 .2 %和 6 1.3% ,月经量明显减少和行经时间明显缩短者分别占 75 .7%和 5 6 .8% ,血红蛋白明显增加者分别占 73.8%和 6 1.9% ,子宫体积和肌瘤体积较治疗前明显减少者占 71.4 %和 5 4 .8%。结论　UAE为治疗子宫肌瘤的有效方法之一 ,其最大优点是微创、保留子宫 ;合理的围术期管理可控制近期并发症 ,无严重远期并发症发生。UAE对卵巢功能的影响有待进一步研究 ,可能与PVA的选择和注入时的压力有关 。Objective To appraise the effectiveness and perioperative management of uterine artery embolization therapy in treating uterine myoma. Methods Abdominal aortography via the femoral artery catheterization was undertaken to visualize the uterine artery and its branches in supplying the myoma. Polyvinyl alcohol (PVA) microparticles were used to embolize the uterine artery. Results Altogether 42 patients were treated with UAE during 1999～2002. Perioperative complications including vaginal bleeding, lower abdominal pain and fever were successfully controlled. 6 months and 12 months follow-up showed 74.2% and 61.3% improvement of the subjective symptoms, decrease of menstrual bleeding and menstration duration 75.7% and 56.8% respectively, elevation of hemoglobin level 73.8% and 61.9% respectively, and shrinkage of uterine myoma 71.4% and 54.8% respectively. Conclusion UAE is one of the effective methods of treating uterine myoma, with minimal invasion and good reservation of the uterus. Complications were mostly mild and can be successfully controlled. The influence of UAE on ovarian function will be further investigated regarding the choice of PVA and injection pressure, especially in women of child bearing age. (Shanghai Med J, 2004,27∶843-845)

关 键 词：治疗 子宫肌瘤 临床应用 子宫动脉栓塞术 UAE 围术期管理 患者 例子 优点 增加 

分 类 号：R737.33[医药卫生—肿瘤]