经导管子宫动脉栓塞术的临床应用  

Clinical application of transcatheter uterine artery embolization

作　　者：张伟国[1] 李力[2] 罗香国[1] 严景恩[1] 陈金华[1] 孙秀梅[1] 刘玲[1] 陈蓉[1] 王毅[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所放射科,重庆400042 [2]第三军医大学大坪医院野战外科研究所妇产科,重庆400042

出　　处：《第三军医大学学报》2005年第3期247-250,共4页Journal of Third Military Medical University

摘　　要：目的　探讨经导管子宫动脉栓塞术 (transcatheteruterinearteryembolization ,TUAE)的方法和技术问题。方法　对 5 5例子宫肌瘤和其他良性病变行TUAE治疗 ,在透视下用 5F COBRA导管或 /和微导管对双侧子宫动脉超选 ,以聚乙烯醇 (PVA)颗粒进行栓塞 ,栓塞程度为子宫动脉内造影剂出现滞流。结果　手术成功率 98%,平均透视时间和手术时间分别为 (2 4 81± 15 80 )min、(60 2 8± 3 3 3 7)min ,随着例数累积增多 ,手术和透视时间有明显减少的趋势 ;PVA平均用量为(119 81± 41 3 7)mg ;并发症较少、较轻 ,1例在操作过程中出现盆腔血肿 ,2例疼痛时间延长 ,7例粘膜下子宫肌瘤有坏死组织从阴道排出。结论　TUAE术成功率高 ,并发症少 ,是治疗子宫肌瘤和其他良性病变的一种新的方法。Objective To explore the methods and techniques for the application of transcatheter uterine artery embolization (TUAE). Methods Fifty-five consecutive patients with hysteromyoma and other uterine benign diseases underwent TUAE. Superselective catheterization of bilateral uterine arteries was completed with 5 French-COBRA catheters or/and microcatheters under the fluoroscope. Polyvinyl alcohol (PVA) particles were embolized into each uterine artery until the abnormal vasculature was occluded and there was slow flow or near stasis in the main uterine artery. Results TUAE was bilaterally successful in 98%. The average procedure time and fluoroscopic time for the group was (60.28±33.37) and (24.81±15.80) min, respectively. With the increased number of patients, both procedure time and fluoroscopic time were reduced gradually. According to the size and abnormal vascularity, the average dose of PVA was (119.81±41.37) mg. The major complications were rare. Of the fifty-five patients, pelvic hematoma was found in 1 patient during the procedure, prolonged pain in 2, and transvaginal expulsion of sloughing tissue in 7 submucous hysteromyomas. Conclusion TUAE, resulting in high successful rate and low complication rate, is a new method for the treatment of hysteromyoma and other uterine benign diseases.

关 键 词：子宫肌瘤 子宫良性病变 子宫动脉栓塞 

分 类 号：R459.9[医药卫生—治疗学] R710.5[医药卫生—临床医学]