子宫动脉栓塞治疗子宫肌瘤的临床效果观察

摘要

Objective To observe clinical therapeutic effect of superselective uterine artery embolization (UAE) for hysteromyoma.Methods 31 patients with hysteromyoma were selected. Femoral artery puncture was done by using Seldinger' s method, and 4F or 5F of RH, Yashiro, Cobra, or RUC catheter was catherized into femoral artery of the patient with hysteromyoma. After the artery was confirmed as supply artery of hysteromyoma by angiography, embolic materials were injected into the artery through a catheter. Embolic materials used for 25 patients were pinyangmycin and lipiodol emulsion(PLE) + gelatin sponge (GS)strip, and those for 6 patients were PVA polyvinyl alcohol particles ( diameter: 250-750μ m) + gelatin sponge (GS) strip. Embolism dose was determined according to size and blood supply of the hysteromyoma in order to completely block blood flow of the uterine artery. Results The success rate of embolization was 100.00％. The symptoms of 31 patients were improved at varied degrees, of which 16 patients cured (accounting for 51.61％ ), those of 12 patients were partially remissed ( accounting for 38.71％ ), and those of 3 patients were ineffective ( accounting for 9.67％ ). The total effective rate was 90.32％. Conclusion Superselective UAE is a safe and effective method for treatment of hysteromyoma.%目的 观察超选择子宫动脉栓塞治疗子宫肌瘤的临床效果.方法 采用Seldinger's方法行股动脉穿刺插管,选用4F或5F的RH、Yashiro、Cobra或RUC导管.造影证实为肿瘤供血动脉后经导管注入栓塞剂栓塞子宫肌瘤.所用栓塞材料为平阳霉素和碘油混合剂+明胶海绵条25例,聚乙烯醇PVA颗粒(直径250～750μm)+明胶海绵条6例.栓塞剂量根据肿瘤大小及血供情况决定,以完全阻断子宫动脉血流为宜.结果 栓塞技术成功率100.00%,31例患者均有不同程度的缓解,其中治愈16例,占51.61%;部分缓解12例,占38.71%;无效3例,占9.67%;总有效率达90.32%.结论 超选择子宫动脉栓塞治疗子宫肌瘤是一种安全有效的治疗方法.