子宫动脉栓塞术治疗症状性子宫肌瘤的疗效及对卵巢功能的影响  

Effect of uterine arterial embolization in treatment of symptomatic uterine fibroids and its effect on ovarian function

作　　者：张莉[1] 高巍[1] 任熙[1] 任艳梅[2] 杨晶晶[1] 郝文斌[1] 

机构地区：[1]河北北方学院附属第二医院妇产科,河北宣化075100 [2]河北北方学院附属第二医院预防保健科,河北宣化075100

出　　处：《海南医学院学报》2016年第7期689-691,695,共4页Journal of Hainan Medical University

基　　金：河北省张家口市科技计划项目(1421104D)~~

摘　　要：目的：探讨子宫动脉栓塞术（UAE）治疗症状性子宫肌瘤临床疗效及对卵巢功能的影响。方法：回顾性分析河北北方学院附属第二医院2014年8月～2015年8月间采用UAE进行治疗的20例症状性子宫肌瘤患者临床资料，于月经干净3～7d进行uAE，采用Seldinger技术穿刺右侧股动脉，海藻酸钠微球颗粒或聚乙烯醇注入靶血管栓塞肌瘤血管，碎明胶海绵颗粒栓塞子宫动脉阻止对肌瘤的供血；采用影像学检查症状性子宫肌瘤患者UAE前及UAE后3个月、6个月、12个月子宫体积和肌瘤体积变化情况；检测UAE前及UAE后3个月、6个月、12个月促黄体生成激素（LH）、泌乳素（PRL）、促卵泡生成激素（FSH）、孕酮（PRoG）、雌二醇（E2）变化情况，并设正常体检组进行对比观察。结果：UAE术后3个月、6个月、12个月进行随访，进行B超检查，子宫与瘤体体积均缩小，随着UAE时间延长，缩小程度差异更明显，差异有统计学意义（P〈0．05）；UAE术前、术后3个月、6个月、12个月LH、PRL、FSH、PROG、E2水平均无明显变化，UAE术前术后差异无统计学意义（P〉0．05），与对照组比较差异无统计学意义（P〉0．05）。结论：采用UAE治疗子宫肌瘤创伤小，疗效确切，同时保留了子宫和卵巢，对卵巢功能影响小，是较好的治疗子宫肌瘤的方法，但对肌瘤及卵巢功能的远期疗效仍需进一步研究。Objective： To investigate the effect of uterine artery embolization （UAE） in the treatment of symptomatic uterine fibroids and the effect on ovarian function. Methods.. A total of 20 cases with uterine leiomyoma treated by UAE admitted from August 2014 to August 2015 were selected. Three to seven days after menstruation, they were treated with UAE. The right femoral artery was punctured using Seldinger technology, alginate microspheres or polyvinyl alcohol particles were injected into the target vessel embolism vascular leiomyoma, and broken Gelfoam embolization of uterine artery was used to stop fibroids blood supply. Imaging examination of symptomatic uterine fibroids was performed to observe uterus and myoma volume changes before and 3 months, 6 months, 12 months after UAE. Luteinizing hormone （LH）, prolaetin （PRL）, follicle stimulating hormone （FSH）, progesterone （PROG）, estradiol （E2） changes before and 3 months, 6 months, 12 months after UAE were observed and compared. Results, All patients were followed up for 3 months. The volume of uterus and tumor volume were reduced, and the degree of reduction was more significant as time went by （P〈0.05）. There was no significant change in LH, PRL, FSH, PROG, E2 after UAE （P〉0.05）. And the difference was no significant compared with control group（P〉 0. 05）. Conelusion： UAE is minimally invasive, and the effect is definite. It can keep uterus and ovary, and has little effect on ovarian function. It is effeetive treatment of uterine leiomyoma.

关 键 词：症状性子宫肌瘤 子宫动脉栓塞术 卵巢功能 

分 类 号：R737.33[医药卫生—肿瘤]