不同栓塞剂栓塞子宫动脉治疗子宫腺肌症的中远期随访分析  

Uterine artery embolization for the treatment of uterine adenomyosis:comparison study of different embolic agents

作　　者：姚群立[1] 陆建东[1] 徐向荣[1] 柳玉华[1] 张建亚[2] 

机构地区：[1]江苏省张家港市中医医院(南京中医药大学附属张家港医院)放射科,215600 [2]江苏省张家港市中医医院(南京中医药大学附属张家港医院)妇产科,215600

出　　处：《介入放射学杂志》2015年第3期248-252,共5页Journal of Interventional Radiology

摘　　要：目的探讨应用不同栓塞剂栓塞子宫动脉治疗子宫腺肌症的临床疗效和并发症的发生情况。方法回顾性分析2004—2011年分别以国产碘化油、海藻酸钠微球和Embosphere微球栓塞子宫动脉治疗的子宫腺肌症患者45例,其痛经等症状变化、子宫磁共振影像改变及临床严重并发症的发生情况进行了为期2年以上的随访。结果术后3组患者痛经程度、月经量等临床症状均有改善,6个月时碘化油组、海藻酸钠微球组和Embosphere微球组痛经明显缓解率分别为33.3%(5/15),30.8%(4/13),41.1%(7/17);12个月时MRI显示子宫体积分别缩小为49.19%、48.25%和50.05%;24个月时有8例患者痛经复发,分别为碘化油组2例,海藻酸钠微球组4例和Embosphere微球组2例。碘化油组发生闭经2例,Embosphere微球组发生闭经1例。结论以碘化油、海藻酸钠微球或Embosphere微球进行超选择性子宫动脉栓塞治疗子宫腺肌症对缓解患者痛经程度、缩小子宫体积具有良好的效果;栓塞治疗发生闭经的原因除卵巢功能减退外,也可能为子宫宫腔粘连;在取得临床疗效相似的情况下,使用颗粒型固体栓塞剂进行栓塞治疗其安全性可能较液体栓塞剂为高。Objective To investigate the clinical effects and complications of uterine artery embolization（UAE） therapy using different embolic agents in treating uterine adenomyosis.Methods During2004—2011,a total of 45 female patients with uterine adenomyosis were admmitted to authors＇ hospital to receive uterine artery embolization therapy.The embolic agents used in the procedures included domestic iodized oil,sodium alginate microspheres and Embosphere microspheres.The patients were randomly divided into group A（n = 15,using domestic iodized oil as embolic agent）,Group B（n = 13,using sodium alginate microspheres as embolic agent） and group C（n = 17,using Embosphere microspheres as embolic agent）.After the treatment,all the patients were followed up for over 2 years,focusing on the observation of the clinical symptoms such dysmenorrheal,changes of MRI signs and severe complications.The results were analyzed and compared among the three groups.Results After UAE,the clinical symptoms such as the degree of dysmenorrhea,menstrual quantity,etc.were improved in all patients.Six months after UAE,the obvious remission rate of dysmenorrheal in group A,B and C was 33.3%（5/15）,30.8%（4/13） and 41.1%（7/17） respectively.Twelve months after UAE,MRI scanning showed that the uterine sizes in group A,B and C were reduced to 49.19%,48.25% and 50.05% respectively.Follow-up examination at 24 months after UAE showed that recurrence of dysmenorrheal in group A,B and C was seen in 2,4 and 2 cases respectively,and amenorrhea was seen in 2 cases of group A and one case in group C.Conclusion The use of domestic iodized oil,sodium alginate microspheres or Embosphere microspheres as embolic agents in performing super-selective uterine artery embolization for adenomyosis can effectively relieve the degree of dysmenorrheal,decrease the uterine size.In addition to ovarian dysfunction,the uterine cavity adhesion may be also a possible cause of amenorrhea occurring after UAE may.In order to ensure a similar clinical efficac

关 键 词：子宫腺肌症 动脉栓塞 栓塞剂 并发症 

分 类 号：R711.71[医药卫生—妇产科学]