【作者】 朱敬松； 王传平； 宋静；

【机构】 郑州大学第二附属医院放射科； 河南北方机电公司医院；

【摘要】 目的评估单纯用明胶海绵颗粒栓塞子宫动脉治疗有症状子宫肌瘤的安全性和临床疗效。资料及方法在38个月时间内,60例有明显症状的子宫肌瘤患者(年龄32-51岁,平均年龄41.8岁)行子宫动脉栓塞术。直径约500—1000μm明胶海绵作为栓塞物质。根据随访结果评估症状改善情况。应用彩色多普- 勒对最大肌瘤体积及子宫体积缩小程度进行评估。随访周期为136个月(平均10.2个月)。结果手术后4 个月42例患者中41例月经量增多得到显著或中度改善(98%),手术后1年20患者20例显著或中度改善(100%); 手术后4个月32例患者中31例与肌瘤体积相关症状显著或中度改善(97%),手术后1年19患者19例显著或中度改善(100%);彩色多普勒显示:手术后4个月最大肌瘤平均缩小率为55%,1年后平均缩小率为70%;术后4个月子宫体积缩小率为40%,1年后平均缩小率为56%。彩色多普勒随访显示无子宫肌瘤再发或残存肌瘤增大。所有患者无严重并发症发生。结论我们认为单纯用明胶海绵颗粒栓塞子宫动脉治疗有症状子宫肌瘤是安全和有效的措施。更多还原

【Abstract】 Objective The purpose of this study was to assess the safety and effectiveness of uterine artery embolization using gelatin sponge particles alone for women with symptomatic uterine fibroids.Materials and Methods During 38 months,60 patients (age range,32-51 years mean age, 41.8 years) with symptomatic uterine fibroids underwent uterine artery embolization.Only gelatin sponge particles,approximately 500-1000 μm in diameter,were used in all patients.The improve- ment of clinical symptoms was assessed by questionnaire.Reduction of the largest tumor and uterine volume reductions were assessed using Color Doppler.The foUow-up period ranged from 1 to 36 months (mean,10.2 months).Results Menorrhagia improved markedly or moderately in 41 (98%) of 42 of patients 4 months after embolization and in 20 (100%) of 20 patients 1 year after embolization. Bulk-related symptoms improved markedly or moderately in 31 (97%) of 32 of patients 4 months after embolization and in 19 (100%) of 19 of patients 1 year after embolization.Color Doppler revealed that the mean largest tumor volume reduction rates were 55% at 4 months and 70% at 1 year after embolization,and the mean uterine volume reduction rates were 40% at 4 months and 56% at 1 year after embolization.Follow-up Color Doppler showed no new fibroids and no regrowth of existing fibroids.No major complications were observed in any women.Conclusion We suggest that uterine artery embolization with gelatin sponge particles alone is a safe and effective treatment for symptomatic fibroids.The outcomes bear comparison with those of uterine artery embolization using polyvinyl alcohol particles,which have been reported in the literature.更多还原