聚乙烯醇颗粒栓塞治疗子宫腺肌病的远期疗效观察  

Long-term curative effects of uterine artery embolization with polyvinyl alcohol granules on adenomyosis

作　　者：唐佳华[1] 张桂萍[1] 米建锋[1] 胡芸[1] Tang Jiahua;Zhang Guiping;Mi Jianfeng;Hu Yun(Department of Gynecology and Obstetrics,The Second People's Hospital of Qinzhou,Qinzhou 535099,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]钦州市第二人民医院妇产科,钦州535099

出　　处：《中国基层医药》2023年第9期1335-1339,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：广西壮族自治区钦州市科学研究与技术开发计划(201410709)。

摘　　要：目的:观察运用聚乙烯醇颗粒(PVA颗粒)栓塞子宫动脉治疗子宫腺肌病的远期疗效及不良反应。方法:选取2009年1月至2017年2月钦州市第二人民医院收治的子宫腺肌病患者60例为研究对象,采用回顾性研究,按照治疗方法不同分为两组:观察组(31例)采用PVA颗粒栓塞子宫动脉治疗,对照组(29例)采用左炔诺酮宫内缓释系统治疗。治疗后随访2~5年,观察其远期疗效,包括痛经症状、月经量、性激素及子宫大小变化情况。结果:治疗后2年,观察组有效率93.5%(29/31),优于对照组的72.4%(21/29)(χ^(2)=4.81,P=0.028);治疗后5年,观察组有效率93.5%(29/31),优于对照组的65.5%(19/29)(χ^(2)=7.35,P=0.007);治疗后,两组患者的子宫大小、月经量、视觉模拟评分法(VAS)评分明显好转(均P<0.05),观察组均优于对照组(均P<0.05);治疗后随访5年,观察组远期不良反应发生率为3.2%(1/31),与对照组[6.9%(2/29)]差异无统计学意义(P>0.05);观察组复发率3.45%(1/29),明显低于对照组的23.81%(5/21)(χ^(2)=4.78,P=0.029);治疗后2、5年,两组患者卵巢功能未受影响。结论:运用PVA颗粒栓塞治疗子宫腺肌病的远期疗效确切、安全,复发率低。Objective To investigate the long-term efficacy and the adverse reactions of uterine artery embolization with polyvinyl alcohol granules in the treatment of adenomyosis.Methods Sixty patients with adenomyosis who received treatment in The Second People's Hospital of Qinzhou from January 2009 to February 2017 were retrospectively included in this study.They were divided into an observation group(n=31)and a control group(n=29)according to different treatment methods.The observation group was treated by embolization of the uterine artery with a polyvinyl alcohol granule.The control group was treated with a levonorgestrel-releasing intrauterine system.After treatment,all patients were followed up for 2-5 years.The long-term efficacy was evaluated,including the symptoms of dysmenorrhea,average menstrual fluid volume,sex hormone,and change in uterine size.Results After 2 years of treatment,the response rate in the observation group was 93.5%(29/31),which was significantly higher than 72.4%(21/29)in the control group(χ^(2)=4.81,P=0.028).After 5 years of treatment,the response rate in the observation group was 93.5%(29/31),which was significantly higher than 65.5%(19/29)in the control group(χ^(2)=7.35,P=0.007).After treatment,the improvements in uterine size,menstrual fluid volume,and visual analogue scale score were greater in the observation group than those in the control group(all P<0.05).After treatment,all patients were followed up for 5 years.There was no significant difference in the incidence of long-term adverse reactions between the observation and control groups[3.2%(1/31)vs.6.9%(2/29),P>0.05].The recurrence rate in the observation group was 3.45%(1/29),which was significantly lower than 23.81%(5/21)in the control group(χ^(2)=4.78,P=0.029).After 2 and 5 years of treatment,ovarian function was not affected in both groups of patients.Conclusion Uterine artery embolization with polyvinyl alcohol granules for the treatment of adenomyosis has identified long-term curative effects,is safe,and has a low recurrenc

关 键 词：子宫腺肌病 子宫动脉栓塞术 痛经 复发 聚乙烯醇颗粒 

分 类 号：R711.71[医药卫生—妇产科学]