子宫动脉栓塞术治疗子宫肌瘤的临床应用价值

目的：研究子宫动脉栓塞术（UAE）治疗子宫肌瘤的安全性和临床应用价值，材料和方法：25例经临床，B超证实的子宫肌瘤患者，平均年龄43．5岁，主要临床表现为月经量增多21例，贫血16例，有压迫症状4例，选择性双侧子宫动脉插管造影，用聚己烯已醇海绵（PVA）颗粒栓塞该动脉。结果：UAE后第3，6个月随访，所有患者月经量均恢复正常，15例贫血，4例压迫症状者均缓解，第3，6个月B超复查子宫肌瘤体积分别缩小47．37％和51．31％，与UAE产比较有显著差异（P＜0．01），缺血性盆腔疼痛（92％）是最常见的副反应，UAE后卵巢体积均无显著缩小（P＞0．05），结论：介入性双侧子宫动脉栓塞术治疗子宫肌瘤是一种微创，安全的手术，可保留子宫及其功能，其近期疗效显著，子宫动脉栓塞治疗子宫肌瘤具有重要的临床应用价值。

Evaluation of Clinical Application of Uterine Artery Embolization for the Treatment of Uterine Leiomyoma

Objective:To evaluate prospectively the clinical application and safety of selective embolization of the uterine arteries in the management of symptomatic uterine leiomyoma. Materials and Methods: A total of 25 consecutive women (mean 43. 5 aged year)with symptomatic uterine leiomyoma were included in this study. Menstrual bleeding was a presenting symptom in 21 patients .anemia was a presenting symptom in 16 patients,pelvic pain and pressure was a presenting symptom in 4 patients. The diagnosis of leiomyoma had previously been confirmed with US findings. After aortoiliac angiography, selective catheterization of the uterine arteries was carried out,and embolization was achieved by deploying PVA. Results: With a mean clinical follow-up of 3 months and 6 months, menstrual bleeding was improved in 100%,with 93. 75% of anemia patients markedly improved. Pelvic pain and pressure was improved in all of patients. At initial US imaging follow-up of 3 months and 6 months,the median dominant fibroid volume decreased 47. 37% and 51. 31% separately (P<0. 01),US imaging showed no ovary volume decrease after UAE (P>0. 05). In 92% cases embolisation caused pelvic pain, which required analgesia in all. Conclusion : Uterine artery embolization for the treatment of uterine fibroids is a minimally invasive technique with low complication rates and satisfactory efficacy. It is important evaluation of clinical application that uterine artery embolization treat the uterine leiomyoma.