子宫动脉栓塞术对子宫肌瘤、子宫腺肌症治疗若干问题初探  

An analysis of the related problems in uterine artery embolization for uterine fibroids and adenomyosis

作　　者：郭文波[1] 杨建勇[1] 陈伟[1] 庄文权[1] 姚书忠[2] 余深平[1] 

机构地区：[1]中山医科大学附属第一医院介入放射科,广东省510080 [2]中山医科大学附属第一医院介入妇产科,广东省510080

出　　处：《放射学实践》2001年第4期243-245,共3页Radiologic Practice

摘　　要：目的 :子宫动脉栓塞术对子宫肌瘤、子宫腺肌症若干问题进行初步探讨。方法 :对 2 8例正常的女性盆腔血管造影进行子宫动脉的分析。对 14例子宫肌瘤、子宫腺肌症的子宫动脉栓塞治疗方法进行前瞻性分析 ,术前均行B超引导下病灶穿刺活检。结果 :正位投照子宫动脉开口显示仅 9.4% ,子宫动脉开口主要被臀上动脉掩盖为 86 .2 1% ;子宫动脉开口显示在左、右前斜位 2 5°～ 30°头侧倾斜 15°对子宫动脉显露最为理想。术前B超诊断与病理诊断符合率肌瘤组 ( 10 /11) 91%、腺肌症组 3例均符合。单侧的子宫动脉卵巢支栓塞 ,术后性激素变化未见异常 ,月经正常来潮卵巢功能未见受损。结论 :栓塞治疗子宫肌瘤和子宫腺肌症中对组织活检病理检查利于客观及科学的评价 ;左右前斜位 2 5°～ 30° ,球管向头侧倾斜 15°是利于显示子宫动脉开口的最佳角度 ;单侧的子宫动脉卵巢支栓塞不会影响卵巢功能。Objective:To analyze the related problems in uterine artery embolization(UAE) for uterine fibroids and adenomyosis.Methods:The normal uterine artery of 28 females undergoing pelvic angiography and 14 patients with uterine fibroids (n=11) and adenomyosis (n=3) undergoing UAE were prospectively analyzed.Biopsy was performed in all cases by ultrasound guiding before operation.Results:The source of uterine artery was demonstrated in only 9.4% on the front projection, 86.21% of which was covered mostly by superior gluteal artery.The ideal demonstration of the uterine artery was on the projection of 25～30 degree toward left or right anterior obliquity with 15 degree at which the tube tilts the head.The rate of ultrasound diagnosis consistent with the result of pathology was 91%(10/11)in uterine fibroids and 100%(3/3)in adenomyosis,respectively.Following the unilateral ovarian branch embolization,the sexual hormone level, menstruation and the function of the overy was normal.Conclusion:Pathological biopsy is in favor of objective and scientific evaluation for interventional treatment for both the diseases.The best angle to reveal the opening of the uterine artery is 25～30 degree of left or right anterior obliquity with 15 degree at which the tube tilts the head.Moreover,a unilateral ovarian branch embolization of uterine artery doesn't affect the ovary function.

关 键 词：子宫腺肌症 同瘤 子宫动脉栓塞术 治疗 

分 类 号：R737.33[医药卫生—肿瘤] R711.71[医药卫生—临床医学]