【摘要】 目的探讨碘油平阳霉素乳剂经导管子宫动脉栓塞(LPE-TUAE)治疗子宫肌瘤的远期疗效及安全性。方法243例子宫肌瘤患者行LPE-TUAE治疗,其中14例于栓塞后3d至6个月行妇科手术切除,标本送病检。另229例随访1～4年,观察症状改善、肌瘤大小与子宫体积变化、卵巢内分泌功能改变及术后并发症。结果月经恢复正常或经血显著减少占96.0%(193/201);下腹部、腰腿胀痛消失或明显缓解占94.9%(94/99),压迫症状消失或显著减轻占96.0%(48/50)。B超复查,栓塞后1年、2年、3年和4年肌瘤平均体积缩小率分别为60.7%、63.3%、65.6%和67.4%,子宫平均体积缩小率分别为49.6%、54.3%、55.2%和57.1%,栓后3～4年肌瘤复发率10.8%(12/111)。卵巢内分泌功能观察栓塞前后无显著变化。手术标本病理观察,碘油仅分布于肌瘤组织,栓后2周肌瘤出现点状坏死,3周出现大量片状坏死,而正常子宫肌组织未见坏死。未见严重并发症发生。结论LPE-TUAE治疗子宫肌瘤具有较好的远期疗效,对卵巢功能及正常子宫肌组织无明显损害,无严重并发症发生。更多还原

【Abstract】 Objective To investigate the long-term efficiency and safety of trans-catheter uterine artery embolization using lipiodol-pingyingmycin emulsion(LPE-TUAE) for uterine fibroids.Methods Two hundred and forty-three patients with uterine fibroids were treated by LPE-TUAE.Fourteen of them underwent hysterectomy or myomectomy 3 days to 6 months after LPE-TUAE.The specimens were studied pathologically.Another 229 patients were followed up for 1 to 4 years to observe the long-term outcomes.Results Menorrhagia became normal or improved markedly in 96.0%(193/201).Lumbago and lower abdominal pain disappeared or relieved markedly in 94.9%(94/99).Bulk-related symptoms disappeared or lessened markedly in 96.0%(48/50).Ultrasound revealed that the average decreased rate in the largest fibroid volume were 60.7%at 1 year,63.3%at 2 year,65.6%at 3 year and 67.4%at 4 year after embolization,and the average decreased rate in the largest uterine volume were 49.6%at 1 year,54.3%at 2 year,55.2%at 3 year and 57.1%at 4 year after embolization.Reoccurrence rate of myoma was 10.8%3-4 year after embolization.No significant difference was found in hormone level between pre- and post-embolization.Pathological studies of specimens showed that lipiodol was only accumulated in fibroids and was not seen in myometrium.Spotty necrosis 2 weeks after embolizaton and extensive patchy necrosis 3 weeks after embolization were occurred in fibroids.Necrosis was not showed in myometrium.No serious complications occurred.Conclusion LPE-TUAE possesses a good long-term effectiveness for uterine fibroids,which doesn’t cause the damage on ovarian function and normal myometrium or serious complications.更多还原