超声引导下瘤体内注射氨甲喋呤治疗子宫肌瘤的临床初步研究  

Treatment of hystero myoma by ultrasound-guided injection of methotrexate

作　　者：苑洪菲[1] 王艳杰[1] 王联连[1] 郭婕姝[1] 孙淑清[1] 李贞淑[1] 

机构地区：[1]武警黑龙江总队医院妇产科

出　　处：《武警医学》2002年第9期517-520,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的　探讨超声引导下经阴道瘤体内注射MTX治疗子宫肌瘤的效果。方法　对 31例子宫肌瘤患者采用超声引导下经阴道瘤体内注射MTX ,剂量 5 0～ 6 0mg ,每月 1次 ,连续注射 3个月 ,定期B超复查 ,观察肌瘤体积的变化。切除的肌瘤标本行光镜和电镜下组织学观察分析并与未注药的同期肌瘤标本相比。结果　注药 1个月后体积与治疗前相比无明显变化 (P >0 0 5 ) ;第 2、3次注药 1个月后肌瘤体积与治疗前相比明显缩小 (P <0 0 1) ,注药 6个月后肌瘤体积与注药 3个月后的体积相比较差异无显著性意义 (P >0 0 5 )。注药后的肌瘤标本光镜下可见其单位视野内的血管数明显减少 ,并有管腔变窄 ,肌瘤细胞有明显的水肿及变性 ;电镜下可见瘤细胞内内质网及线粒体有明显的水肿及变性。结论　超声引导下经阴道MTX瘤体内注药治疗子宫肌瘤疗效确切 。Abstrat Objective To observe the results of the treament of hystero myoma by ultrasound guided injection of methotrexate(MTX) into myoma transvaginally.Methods 50～60 mg of MTX was injected into hystero myoma in 31 patients once a month for 3 consecutive months,with ultrasound checkup at regular intervals to observe the change of the size of myoma.The changes of blood supply before and after the injection were observed with color Doppler ultrasound.Two of the enrolled patients underwent operation one month after the injection.The removed specimens were observed under light microscope and electronicmicroscope,compared with the specimens not treated with MTX.Results The mean tumor size of 31 patients was (59.21±21.76) cm 3 before the injection and it decreased to (48.57±25.87) cm 3 one month after the first injection(P>0.05).One month after the second and third injections,the tumor sizes were significantly decreased,compared with those before the treatment (P<0.01).The tumor size was (30.51±17.37) cm 3 at 6 month,which was not significantly different from that at 3 months (P>0.05).Under the light microscope,blood vessels in the two removed tumor specimens showed sparse distribution,indicating that blood vessels decreased in number and became narrower.Apparent degeneration and edema were found in leiomyoma tissues.Under the electronic microscope,degeneration and edema were observed in mitochondria and endoplasmic reticulum.Conclusions Ultrasound guided injection of MTX into hystero myoma transvaginally has satisfactory definite short term effects.It is easily performed and has little side effect.

关 键 词：超声引导 瘤体内注射 氨甲喋呤 治疗 子宫肌瘤 临床研究 

分 类 号：R737.33[医药卫生—肿瘤]