不同栓塞剂栓塞子宫动脉治疗子宫腺肌症的中远期随访分析

发布时间：2018-07-02 22:27

本文选题：子宫腺肌症 + 动脉栓塞　；参考：《介入放射学杂志》2015年03期

【摘要】：目的探讨应用不同栓塞剂栓塞子宫动脉治疗子宫腺肌症的临床疗效和并发症的发生情况。方法回顾性分析2004—2011年分别以国产碘化油、海藻酸钠微球和Embosphere微球栓塞子宫动脉治疗的子宫腺肌症患者45例,其痛经等症状变化、子宫磁共振影像改变及临床严重并发症的发生情况进行了为期2年以上的随访。结果术后3组患者痛经程度、月经量等临床症状均有改善,6个月时碘化油组、海藻酸钠微球组和Embosphere微球组痛经明显缓解率分别为33.3%(5/15),30.8%(4/13),41.1%(7/17);12个月时MRI显示子宫体积分别缩小为49.19%、48.25%和50.05%;24个月时有8例患者痛经复发,分别为碘化油组2例,海藻酸钠微球组4例和Embosphere微球组2例。碘化油组发生闭经2例,Embosphere微球组发生闭经1例。结论以碘化油、海藻酸钠微球或Embosphere微球进行超选择性子宫动脉栓塞治疗子宫腺肌症对缓解患者痛经程度、缩小子宫体积具有良好的效果;栓塞治疗发生闭经的原因除卵巢功能减退外,也可能为子宫宫腔粘连;在取得临床疗效相似的情况下,使用颗粒型固体栓塞剂进行栓塞治疗其安全性可能较液体栓塞剂为高。
[Abstract]:Objective to investigate the clinical efficacy and complications of uterine artery embolization with different embolization agents in the treatment of adenomyosis. Methods Forty-five patients with adenomyosis treated with domestic iodized oil, sodium alginate microspheres and Embosphere microspheres from 2004 to 2011 were analyzed retrospectively. The changes of magnetic resonance imaging and the occurrence of severe clinical complications were followed up for more than 2 years. Results the degree of dysmenorrhea, menstrual volume and other clinical symptoms were improved in the 3 groups after operation. The apparent relief rates of dysmenorrhea in sodium alginate microsphere group and Embosphere microsphere group were 33.3% (5 / 15) and 30.8% (4 / 13), 41.1% (7 / 17), respectively, at 12 months, the uterine volume was reduced to 49.198.25% and 50.05%, respectively, at 24 months, there were 8 cases of dysmenorrhea recurrence, 2 cases in lipiodol group, 2 cases in iodized oil group. Sodium alginate microspheres group (n = 4) and Embosphere microsphere group (n = 2). Amenorrhea occurred in 2 cases in iodized oil group and 1 case in Embosphere microsphere group. Conclusion superselective uterine artery embolization with iodized oil, sodium alginate or Embosphere microspheres can relieve dysmenorrhea and reduce uterine volume in patients with adenomyosis. In addition to ovarian dysfunction, uterine cavity adhesion may be the cause of embolization, and the safety of embolization with granular solid embolization may be higher than that of liquid embolization in the case of similar clinical efficacy.
【作者单位】：江苏省张家港市中医医院(南京中医药大学附属张家港医院)放射科;江苏省张家港市中医医院(南京中医药大学附属张家港医院)妇产科;
【分类号】：R711.71

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