摘要
【目的】探讨子宫动脉栓塞对子宫腺肌病的中期临床疗效和并发症。【方法】对17例子宫腺肌病患者进行子宫动脉栓塞治疗,在栓塞前和栓塞后每次月经后,评估所有病人的痛经和月经量的变化,并且采用经阴道彩色能量多谱勒超声对子宫及病灶进行动态监测,监测时间定于栓塞前、栓塞后当天、栓塞后第5天和每次月经后。随访5￣44个月(平均21个月)。【结果】栓塞前痛经和月经过多17例。痛经和月经过多缓解情况为:有效15/17(88%),无效2/17(12%)。彩色多谱勒超声监测发现,栓塞前病灶血流信号丰富,栓塞后当天病灶和肌层血流信号消失,栓塞后第5天和其后每次月经后复查病灶和肌层血流信号恢复。超声检查发现子宫和病灶体积在栓塞后一月开始缩小,栓塞后3个月缩小明显,此后子宫和病灶的体积维持稳定,没有变化。栓塞后发热发生率13/17(76%),阴道出血发生率为12/17(71%)。栓塞后怀孕并顺产2例。【结论】子宫动脉栓塞治疗子宫腺肌病是一种新颖、微创、安全、有效、并发症少和恢复快的治疗方法,中期疗效显著。彩色多谱勒能量超声可以有效地评价疗效和判断预后,以及有助于筛选适应症。
[Objective] To investigate the clinical response of uterine artery embolization (UAE) for the treatment of adenomyosis and complications of UAE. [Methods] UAE was performed in 17 cases with adenomyosis. The embolic agent was polyvinyl alcohol particles (PVA). The degree of dysmenorrhea and the menstrual blood volume were evaluated before and after embolization. The uterus and the lesion were examined with transvaginal color Doppler energy sonography (TVCDES) before UAE and the 1st day, 5th day, the day after the menses was over after UAE. All patients had been followed up from 5 to 44 months (average 21 months). [Results] There were dysmenorrhea and menorrhagia in 17 patients. The dysmenorrhea and menorrhagia were relieved in 15/17 (88%) and was not changed in 2/17 (12%). The TVCDES showed that there were rare or no blood flow signal in lesion on the day after UAE. But the blood flow signal had been being recovery and rich in myometrium and lesions since the 5th day after UAE. The blood flow signals were rich in lesion before embolization. But the blood flow signals were not detected in lesion and myometrium on the day of embolization. The blood flow signals were detected in lesion and myometrium on the 5th day later after embolization and from then on. The volume of uterus and lesion started to shrink 1 month later after embolization. The shrinkage of them reached to maximum three months later and stabilized from then on. The fever occurred in 13 patients. The vaginal bleeding occurred in 12 patients. Two patients were pregnant and gave birth successfully after embolization. [Conclusion] Uterine artery embolization for adenomyosis is a new, less-traumatic, safe, effective, less-complications and short-time recovery therapy. Its midterm effects are satisfied. TVCDES can evaluate the effectiveness and estimate prognosis of UAE for adenomyosis. It is helpful in selecting the indications for UAE.
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2005年第4期467-469,480,共4页
Journal of Sun Yat-Sen University:Medical Sciences
