子宫动脉栓塞术在治疗子宫肌瘤中的应用

发布时间：2018-12-19 18:16

【摘要】：目的：回顾性分析应用子宫动脉栓塞术(UAE)治疗子宫肌瘤的临床疗效。方法：选择自2003至2005年于延边医院就诊的150例子宫肌瘤患者,对其进行子宫动脉栓塞术。检测术后副反应,对比UAE术后3、6、12、24个月后患者的临床症状、子宫和肌瘤体积与术前的变化。结果：本组病例术后均出现不同程度的栓塞后综合症,给予对症治疗后症状逐渐减轻；术后6个月观察,在50例术前有明显经量改变的患者中,9例月经无明显改变,41例经量明显减少,经期缩短；27例渐进性痛经患者痛经症状明显减轻；3例经期缩短患者恢复正常；14例阴道不规则流血患者均有明显好转；术后12个月63例轻、中度贫血患者Hb回归至正常水平；2例重度贫血患者,术后Hb升高至90g/L以上；盆腔压迫症状患者中85%术后明显改善,15%轻度改善；术后3个月开始子宫及肌瘤体积分别缩小38.1%和48.3%,6-24个月两者均呈进行性缩小；10例粘膜下肌瘤6-12个月后经阴道自行排除；术后6、12、24个月总有效率分别为90.2%(治愈：10.2%,显效：67.4%,有效：12.6%)、96.3%(治愈：10.4%,显效：79.6%,有效：6.3%)、98.3%(治愈：10.9,显效：85.1%有效：2.3%),显效率和总有效率与术后时间呈正相关。结论：1、应用子宫动脉栓塞术治疗子宫肌瘤效果显著,可明显缩小子宫及肌瘤的体积,缓解临床症状,改善患者生活质量,适用于有生育要求的年轻患者和不愿接受手术治疗者。2、经子宫动脉栓塞术治疗后副反应及并发症是有限的、可控的。
[Abstract]:Objective: to retrospectively analyze the clinical effect of uterine artery embolization (UAE) in the treatment of uterine leiomyoma. Methods: one hundred and fifty patients with uterine leiomyoma from 2003 to 2005 in Yanbian Hospital were treated with uterine artery embolization. The clinical symptoms, uterine and myoma volumes, and preoperative changes were compared between the patients with UAE and 612,24 months after UAE. Results: postembolization syndrome appeared in all the patients after operation, and the symptoms gradually alleviated after the treatment. 6 months after operation, among 50 patients with significant changes in menstrual volume before operation, 9 cases had no significant change in menstruation, 41 cases had significantly decreased menstrual volume, and 27 cases with progressive dysmenorrhea had reduced dysmenorrhea symptoms. After 12 months, 63 patients with mild and moderate anemia returned to normal level, 2 patients with severe anemia, Hb increased to more than 90g/L after operation, 3 patients with shortened menstrual period returned to normal, 14 patients with irregular vaginal bleeding improved significantly, 63 patients with mild and moderate anemia returned to normal level at 12 months after operation, 2 patients with severe anemia increased to 90g/L after operation. In 85% of the patients with pelvic compression symptoms, the volume of uterus and myoma decreased by 38.1% and 48.3% respectively at 3 months after operation and gradually decreased in 15% and 6 to 24 months after operation, and the volume of uterus and leiomyoma decreased gradually from 3 months to 24 months after operation. 10 cases of submucous myoma were removed by vagina after 6-12 months. The total effective rates were 90.2% in 612 months and 24 months after operation (cure: 10.2um, remarkable effect: 67.4and effective: 12.6%), and 96.3% (cure: 10.4%, remarkable effect: 79.6%, effective: 6.3%). 98.3% (cure: 10.9, effective: 85.1%: 2.3%), the effective rate and total effective rate were positively correlated with the postoperative time. Conclusion: 1. Uterine artery embolization can significantly reduce the volume of uterus and myoma, relieve clinical symptoms and improve the quality of life of patients. Suitable for young patients with fertility requirements and unwilling to undergo surgical treatment. 2. Side effects and complications after transuterine arterial embolization are limited and controllable.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.33

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