子宫动脉甲氨蝶呤灌注栓塞治疗子宫腺肌病临床研究  

Uterine Arterial Methotrexate Infusion and Embolization in the Treatment of Uterine Adenomyosis

作　　者：刘海莉[1] 李牧[1] 曹頔[1] 彭玉萍[2] 

机构地区：[1]西安交通大学医学院第二附属医院妇产科,陕西西安710004 [2]西安交通大学医学院第二附属医院放射科,陕西西安710004

出　　处：《昆明医科大学学报》2013年第1期83-85,共3页Journal of Kunming Medical University

基　　金：陕西省科技攻关基金资助项目(2003K10-G66)

摘　　要：目的探讨血管数字减影术(digital subtraction angiography,DSA)下经导管甲氨蝶呤(methotrexate,MTX)局部灌注子宫动脉栓塞治疗子宫腺肌病的临床疗效.方法对18例根据临床症状、彩色超声检查诊断为子宫腺肌病的患者,用Seldinger方法完成子宫动脉超选择性插管,造影证实后用MTX 50 mg灌注,并加用聚乙烯醇(PVA)微球颗粒(直径350～560μm)栓塞治疗.术后观察MTX灌注子宫动脉栓塞前后患者月经量、痛经程度、子宫体积及性激素水平等变化.结果 MTX局部灌注结合子宫动脉栓塞术,无化疗药物不良反应,经治疗的18例患者月经量减少,痛经程度减轻,子宫体积明显缩小,统计学处理有显著差异(P<0.05),而卵巢性激素水平手术前后无明显差异(P>0.05).结论微创介入技术和药物相结合治疗子宫腺肌病疗效确切,为临床提供了一种新的治疗方法.Objective To investigate the therapeutic effects of transcatheter local infusion of methotrexate（MTX） combined with uterine arterial embolization under guidance of digital subtraction angiography on uterine adenomyosis.Methods Total 18 patients with uterine adenomyosis according to clinical symptoms and color Doppler were enrolled in the trial.Super-selective uterine arterial catheterization was performed with Seldinger methods.The patients were then treated with uterine arterial local infusion 50 mg MTX and embolization with PVA microsphere（diameter 350-560 um）,individually.Finally,we observed in menstruation volumes,the degree of dysmenorrheal,uterine sizes,and sex hormone levels changes.Results The uterine arterial local infusion combined with embolization showed no chemotherapeutic side effects.In all cases,there were decrease of menstruation amount,alleviated dysmenorrheal,reduction of uterine size（P0.05）,while no difference was found in levels of sex hormones（P0.05）.Conclusion Micro-invasive interventional technique combined with drug therapy has stable efficacy,and provide a new method for clinical treatment of uterine adenomyosis.

关 键 词：子宫腺肌病 甲氨蝶呤 局部灌注 介入治疗 

分 类 号：R711.71[医药卫生—妇产科学]