子宫动脉栓塞治疗子宫腺肌病中长期疗效观察  

Long-term results and influencing factors of uterine artery embolization in the treatment of adenomyosis

作　　者：陈春林[1] 祝江红[1] 刘萍[1] 马奔[2] 王黎[1] 唐怡欣[1] 徐玉静[1] 

机构地区：[1]南方医科大学南方医院妇产科,广东广州510515 [2]广州市第一人民医院妇科,广东广州510180

出　　处：《中国实用妇科与产科杂志》2013年第6期434-437,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家自然科学基金(30970762);广东省自然科学基金(10151051501000102)

摘　　要：目的探讨单纯子宫腺肌病与合并子宫肌瘤的子宫腺肌病行子宫动脉栓塞治疗的5年痛经疗效。方法选择1999年6月至2005年11月于广州市第一人民医院接受子宫动脉栓塞治疗的167例症状性子宫腺肌病患者,根据磁共振检查结果将其分为合并子宫肌瘤组(A组,47例)及单纯子宫腺肌病组(B组,120例)。评估两组患者手术前后痛经分级的变化。结果中位随访时间72个月(3～120个月),术后1～5年随访率分别为85.6%(143/167)、82%(137/167)、78.4%(131/167)、71.9%(120/167)、64.7%(108/167)。合并子宫肌瘤组子宫动脉栓塞术后1～5年的临床有效率分别为85.71%(36/42)、85%(34/40)、78.95%(30/38)、80.55%(29/36)、79.41%(27/34);单纯子宫腺肌病组子宫动脉栓塞术后1～5年的临床有效率分别为78.21%(79/101)、72.16%(70/97)、66.67%(62/93)、65.47%(55/84)、58.11%(43/74)(P值分别为0.30、0.11、0.16、0.10、0.03),两组的有效率均呈下降趋势;合并子宫肌瘤组有效率高于单纯子宫腺肌病组,术后5年两组的有效率比较差异有统计学意义。结论单纯子宫腺肌病子宫动脉栓塞治疗5年痛经疗效较好;合并子宫肌瘤的子宫腺肌病疗效优于单纯子宫腺肌病。Objective To evaluate the dysmenorrhea score of uterine adenomyosis with or without uterine leiomyomata after uterine artery embolization （UAE） and explore the technique of UAE. Methods 167 women with symptomatic uterine adenomyosis with or without combined uterine leiomyomata diagnosed by magnetic resonance imaging underwent UAE between June 1999 and November 2005. They were divided into two groups . Group A was adenomyosis with combined uterine leiomyomata and group B was not. Dysmenorrhea score of patients five years after UAE were collected. Results Patients were ibllowed for a median of 72 months（ range 3 - 120 months） ,The follow-up rate of 1 to 5 years after UAE was 85.6% （ 143/167 ） ,82% （137/167） ,78.4% （131/167） ,71.9% （120/167） ,64. 7% （ 108/167 ）, respectively. The Clinical effect rate of 1 to 5 years after UAE of group A was 85. 71% ,85% ,78.95% ,80. 55% ,79.41% ,respectively. It was 78.21% ,72. 16% ,66. 67% ,65.47% ,58. 11% in group B, respectively（P =0. 30,0. 11,0. 16,0. 10,0. 03）. The efficient rate of two groups were tending to decline. Significant difference between women with pure uterine adenoymosis and women with uterine adenomyosis combined with uterine leiomyomata was observed in the fifth year. Conclusion We should select different diameter and dose of embolic agents according to the blood supply features when uterine artery embolization treat for simple adenomyosis and adenomyosis with hysteromyoma, in order to achieve complete embolism and to improve clinic effects.

关 键 词：子宫动脉栓塞术 子宫腺肌病 子宫肌瘤 疗效 痛经 

分 类 号：R713.4[医药卫生—妇产科学]