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1.
平阳霉素碘油乳剂动脉灌注在富血性肿瘤介入治疗中的应用   总被引:24,自引:3,他引:21  
目的 评价平阳霉素碘油乳剂(pingyangmycin-lipiodol emulsion,PLE)动脉灌注治疗富血性良恶性肿瘤的疗效和安全性。方法 对80例良性肿瘤经动脉灌注PLE,随访2~12个月观察疗效及并发症。结果 除1例上肢血管瘤外,其余肿瘤血管床灌注后均有碘油沉积。颜面部、上肢、椎体血管瘤及子宫肌瘤临床症状明显改善。肝海绵状血管较均上或消失。肝癌患者DSA造影见肿瘤血管变细或减少,肾癌  相似文献   

2.
目的:探讨经导管子宫动脉栓塞术(UAE)治疗症状性子宫肌瘤的临床疗效及副反应。方法:选择有明显临床症状的32例子宫肌瘤患者,运用Seldinger技术超选择性子宫动脉插管,以平阳霉素碘油乳剂进行栓塞,术后3个月、6个月、8个月1、2个月观察疗效。结果:32例患者在术后随访12个月,子宫体积平均缩小60.6%,肌瘤体积平均缩小76.3%。所有病例,月经恢复正常,贫血改善,压迫症状基本消失,未出现严重并发症。结论:UAE治疗症状性子宫肌瘤是一种疗效显著、安全性高的微创治疗方法。  相似文献   

3.
目的:探讨子宫动脉栓塞治疗子宫肌瘤的疗效。方法:28例子宫肌瘤患者接受子宫动脉栓塞治疗,观察栓塞治疗3和6个月后复查瘤体大小及临床症状改变情况。结果:肌瘤由子宫动脉分支供血,双侧血供型占绝大多数.治疗后6个月复查,所有肌瘤均比治疗前缩小,临床症状明显改善。结论:子宫肌瘤栓塞治疗是一种微创性、能保留子宫、安全有效的新疗法,其近期疗效优良。  相似文献   

4.
目的探讨应用碘油、PVA、明胶海绵颗粒介入治疗子宫肌瘤的临床效果.方法对36例子宫肌瘤进行选择性双侧子宫动脉栓塞灌注碘油、PVA、明胶海绵,随访3~20个月,平均9个月,观察术后症状缓解情况,子宫缩小和肌瘤缩小程度.结果36例右侧股动脉穿刺操作全部成功.子宫肌瘤动脉造影,表现为子宫动脉明显增粗、迂曲、分支增多、子宫增大、肿瘤染色灶明显.栓塞后肌瘤染色灶明显消失,栓塞剂加用抗生素,术后反应(发热、疼痛、呕吐)明显减轻,子宫肌瘤缩小率46.3%~91.7%,其中肌瘤缩小50%以上占86.6%,性激素术前、术后无明显差异.结论综合应用碘油、PVA、明胶海绵颗粒介入治疗子宫肌瘤是非手术治疗的良好方法.  相似文献   

5.
子宫肌瘤介入治疗47例近期疗效分析   总被引:5,自引:0,他引:5  
目的 探讨子宫动脉栓塞治疗子宫肌瘤的疗效。方法  47例子宫肌瘤患者采用Seldinger’s方法行子宫动脉栓塞 ,观察介入治疗 3和 6个月后复查瘤体大小及临床症状改变情况。结果 肌瘤由子宫动脉分支供血 ,双侧血供型占绝大多数 ,治疗后 6个月复查 ,肌瘤均比治疗前缩小 ,临床症状明显改善。结论 子宫肌瘤子宫动脉栓塞后近期疗效优良。宫腔浸润麻醉可明显降低治疗后盆腔疼痛的发生率。  相似文献   

6.
目的:评价平阳霉素碘油乳剂(Pinyangrnyein lipiodol emulsion,PEE)选择性子宫动脉栓塞治疗症状性子宫肌瘤的疗效和副作用。方法:采用Seldinger方法作选择性子言动脉栓塞治疗15例子宫肌瘤患者。结果:插管栓塞成功率100%,随访1-6个月。B超示术后随访1个月肌瘤体积平均缩小25%。随访6个月,5例肌瘤消失,10例肌瘤体积平均缩小68%,并均伴有月经量的明显减少。结论:PLE选择性子宫动脉栓塞为非手术治疗症状性子宫肌瘤的较好方法。  相似文献   

7.
高压明胶海绵微粒动脉内栓塞治疗子宫肌瘤的临床观察   总被引:1,自引:0,他引:1  
目的:评价高压明胶海绵微粒作为栓塞剂动脉内栓塞治疗症状性子宫肌瘤的安全性和有效性。方法:用高压明胶海绵微粒动脉内栓塞治疗173例子宫肌瘤患者,随访3~36个月,平均15.7个月,观察临床疗效、肌瘤和子宫体积的变化。结果:术后4个月总的症状改善率98.84%(171/173),160例(92.49%)患者术后月经完全恢复正常;5例(2.89%)患者出现术后永久闭经;痛经与直肠和膀胱压迫等症状均完全消失。术后6个月子宫体积平均缩小49.35%,肌瘤平均缩小59.78%。结论:采用高压明胶海绵微粒作为栓塞剂栓塞子宫动脉治疗症状性子宫肌瘤是一种经济、安全、有效的新方法。  相似文献   

8.
子宫肌瘤的介入治疗   总被引:9,自引:4,他引:5  
目的 评价子宫动脉栓塞术治疗子宫肌瘤的疗效。方法 对 182例子宫肌瘤患者进行超选择性子宫动脉栓塞术。结果 栓塞双侧子宫动脉 173例 ,单侧 9例。 168例完整随访者术后 6个月子宫体积平均缩小 42 % ,16例肌瘤消失 ,15 2例肌瘤体积平均缩小 67%。临床症状明显改善。主要副作用为下腹部疼痛 ( 13 5 /182 )。结论 子宫动脉栓塞术是治疗子宫肌瘤的良好方法。  相似文献   

9.
目的 探讨选择性子宫动脉栓塞术治疗症状性子宫肌瘤的疗效和安全性.方法 2005年1月至2009年6月在复旦大学附属妇产科医院就诊的85例症状性子宫肌瘤行子宫动脉栓塞术,症状包括月经量增多、经期延长和邻近器官压迫为主要症状的子宫肌瘤患者,通过超选择性双侧子宫动脉插管,以直径500~710μm的聚乙烯醇颗粒和明胶海绵栓塞子宫动脉.结果 栓塞成功率达100%,无严重并发症.随访6~36个月,所有病例月经恢复正常;贫血病例,血红蛋白升至正常范围.术后6个月肌瘤平均缩小57.5%.结论 子宫肌瘤栓塞治疗创伤小,保留子宫,并发症少,是临床效果确切的一种新治疗方法.  相似文献   

10.
影响子宫肌瘤栓塞治疗的因素   总被引:2,自引:0,他引:2  
目的观察子宫动脉栓塞术(UAE)对子宫肌瘤的治疗效果,并分析影响疗效的因素。方法46例症状性子宫肌瘤患者经超选择性插管双侧子宫动脉内注入PVA微粒栓塞治疗,术后6、9个月随访复查,观察临床症状改善,肌瘤体积变化情况,并对临床上治疗效果与多种不同的影响因素进行分析。结果UAE术后临床症状改善,尤其以子宫出血症状改善最为明显,栓塞后6个月肌瘤体积平均缩小45.6%,9个月肌瘤体积平均缩小58.4%。盆腔内血管解剖、内分泌、栓塞技术及肌瘤类型等因素影响子宫肌瘤栓塞后的疗效。结论双侧子宫动脉栓塞治疗子宫肌瘤是一种安全、有效的方法,其疗效与盆腔内血管解剖、内分泌、栓塞技术及肌瘤类型等多种因素有关。  相似文献   

11.
子宫肌瘤介入治疗临床疗效观察(附21例报告)   总被引:55,自引:2,他引:53  
目的 评价运用无水乙醇双侧子宫动脉栓塞术治疗子宫肌瘤的临床疗效。方法 21例子宫肌瘤患者均采用经皮股动脉穿刺双侧子宫动脉插管,其中超选择至双侧子宫动脉远段16例,8单侧3例,用无水乙醇栓塞;另2例在子宫动脉近端用明胶海绵条栓塞。结果 所有病例随访3-64个月(平均25个月),19例无水乙醇栓塞病例,其中15例临床症状消失,4例明显改善;2例明胶海绵条栓塞病例,2个月及5个月后临床症状有所复发。B超示瘤体体积缩小40%-90%。无一例严重并发症发生。结论 子宫肌瘤的介入治疗是一种安全、有效的治疗方法,尚需进一步观察远期疗效。  相似文献   

12.
INTRODUCTION: We report our preliminary experience with arterial embolization of uterine fibroids in seven women, focusing on the technical aspects of the procedure and the clinical and morphological results during the follow-up. MATERIAL AND METHODS: February to December 1999 seven women (mean age 47) underwent transcatheter arterial embolization of both uterine arteries as a permanent treatment for fibroids. We included in this study single or multiple, bleeding and/or large fibroids, symptomatic on compression, contraindicated for myomectomy because of high surgical or anesthesiologic risks or myomata in which myomectomy could probably be converted into hysterectomy. Fibroids enlarging the uterus to the size of 25 weeks' pregnancy or more, pedunculated myomata or small submucous fibroids--smaller than 5 cm--were excluded. Uterine arterial embolization was performed bilaterally, till a total blockage of flow, by injecting permanent embolization material: polyvinyl-alcohol (PVA) particles of increasing size from 150 to 500 mu and in varying amounts from 10 to 24 mL, depending on fibroid size and degree of vascularization. RESULTS: A technical success was achieved in all cases and no late complications were seen. At 6-month clinical follow-up all compressive symptoms had disappeared; regular menses had returned in 57% of patients, milder hyper-dysmenorrhea was present in 28% compared to pretreatment symptoms; only in one case (14%) was permanent amenorrhea observed. The 3-month and 6-month US follow-up studies showed an average 40.7% (range 10-50%) and 51% (range 25-83%) reduction in the fibroid size, respectively. All the small myomata (about 2 cm in size) were unidentifiable at 6-month US follow-up. In no cases did new fibroids appear. DISCUSSION: Surgery is the traditional treatment for symptomatic uterine fibroids (hysterectomy, myomectomy). More recently, hormone therapy and operative endoscopy (laparoscopy and hysteroscopy) have been introduced as alternatives, together with uterine embolization previously applied preoperatively in extensive bleeding neoplasms or to control post-partum hemorrhage. Transcatheter embolization of the uterine arteries feeding large fibroids is a minimally invasive technique which could be safely used as an alternative to surgery, and a valuable in the definitive treatment of symptomatic, large or multiple, intramural or submucosal fibroids. In agreement with literature findings, in the present series symptoms resolved completely in over 85% of cases after embolization, with an average reduction in fibroid size over 50% at 6-month follow-up in large fibroids, whereas smaller size myomata were no longer detectable at US and no new fibroids had formed. CONCLUSIONS: Our preliminary experience confirms that arterial embolization is a promising alternative to surgery in the definitive treatment of fibroids, thanks to its high efficacy and safety, also reducing patient hospitalization and costs.  相似文献   

13.
子宫动脉栓塞治疗子宫肌瘤的中远期随访研究   总被引:45,自引:3,他引:42  
目的 探讨子宫动脉栓塞治疗子宫肌瘤中远期的临床疗效。方法 对632例子宫肌瘤患者进行选择性子宫动脉造影及栓塞治疗,并进行术后随访。其中随访6个月546例,12个月395例,24个月247例,36个月45例,48个月9例.观察子宫肌瘤血供特点、临床疗效、雌性激素的变化、生育情况、肌瘤复发率。结果 血管造影显示子宫肌瘤以一侧子宫动脉供血为主占62.97%,双侧子宫动脉同时供血占33.70%,卵巢动脉参与供血占1.58%,一侧子宫动脉发育缺如占1.74%.随访546例患者,治愈者占12.82%,显效者占67.21%,有效者占13.55%,无效者占6.41%,16例患者自然受孕或避孕失败而受孕,已生产9例,随访6~48个月未发现术后再发肌瘤。结论 子宫动脉栓塞治疗子宫肌瘤的方法行之有效,对黏膜下子宫肌瘤可以达到治愈效果.  相似文献   

14.
PURPOSE: To evaluate the midterm results of limited embolization of the uterine arteries in the management of symptomatic uterine fibroids and to evaluate the efficacy and safety of limited uterine artery embolization (UAE) with use of calibrated tris-acryl gelatin microspheres in the management of symptomatic uterine fibroids. MATERIALS AND METHODS: Twenty women (mean age, 43 years) with symptomatic uterine fibroids underwent bilateral embolization of the uterine arteries with use of calibrated microspheres. Devascularization of the fibroids was achieved and the main uterine artery was left patent in all women. Embolization was offered as an alternative to surgery in all women who had been treated unsuccessfully with medical therapy. RESULTS: All procedures were technically successful. Microspheres 700-900 micro m in diameter were used in 14 women (70%). After a mean follow-up duration of 30.2 months (range, 24-48 mo), all women reported improvement in their symptoms, with 85% reporting complete resolution of menorrhagia at the most recent follow-up. One woman with multiple fibroids required a second embolization procedure because of persisting symptoms at 6 months. She is currently symptom-free after 48 months. In two women with submucosal fibroids, expulsion of necrotic fibroids occurred 2 and 7 months after the procedure, respectively. All women resumed normal menstruation after the procedure. One woman had a successful full-term pregnancy after embolization. CONCLUSION: Early experience with UAE with use of calibrated tris-acryl gelatin microspheres indicates that it is safe and efficacious in controlling menorrhagia.  相似文献   

15.
经导管动脉栓塞术在子宫肌瘤中的应用   总被引:4,自引:1,他引:3  
目的 探讨经导管超选择性子宫动脉栓塞术治疗子宫肌瘤的临床应用价值。方法  10 3例子宫肌瘤 ,采用双侧子宫动脉插管造影和栓塞治疗 ,栓塞剂为聚乙烯醇 (PVA)和明胶海绵。 67例栓塞后随访资料完整 ,并对造影所见、治疗后反应、症状变化和肌瘤大小改变进行总结和分析。结果 造影表现为子宫动脉增粗、扭曲及肿瘤染色。治疗后数月内月经增多症状均有不同程度改善 ,肌瘤均有缩小 ,肌瘤缩小程度随时间延长而显著。结论 经导管子宫动脉栓塞术对控制症状、缩小肌瘤体积有显著作用 ,是一种安全、有效的治疗子宫肌瘤的方法  相似文献   

16.
Uterine artery embolization for adenomyosis without fibroids   总被引:24,自引:0,他引:24  
Kim MD  Won JW  Lee DY  Ahn CS 《Clinical radiology》2004,59(6):520-526
AIM: To evaluate the potential usefulness of transcatheter uterine artery embolization as a treatment for symptomatic adenomyosis in patients without uterine fibroids. MATERIALS AND METHODS: Uterine artery embolization using polyvinyl alcohol particles sized 250-710 mm was performed in 43 patients (mean; 40.3 years, range; 31-52 years) with dysmenorrhoea, menorrhagia, or bulk-related symptoms (pelvic heaviness, urinary frequency) due to adenomyosis without fibroids. All patients underwent pre-procedural and 3.5 months (range 1-8 months) follow-up magnetic resonance imaging (MRI) with contrast enhancement. Clinical symptoms were also assessed at the time of MRI before and after embolization. RESULTS: Significant improvement of dysmenorrhoea (95.2%) and menorrhagia (95.0%) was reported in most patients. Contrast-enhanced MRI revealed non-enhancing areas suggesting coagulation necrosis of adenomyosis in 31 patients (72.1%), decreased size without necrosis in 11 patients (25.6%), and no change in one patient (2.3%). The mean volume reduction of the uteri after uterine artery embolization was 32.5% (from 321.7+/-142.9 to 216.7+/-130.1 cm(3)). CONCLUSION: Transcatheter uterine artery embolization is an effective therapy for the treatment of symptomatic pure adenomyosis, and may be a valuable alternative to hysterectomy.  相似文献   

17.
PURPOSE: To assess the magnetic resonance imaging (MRI) signal and contrast-enhancement features of uterine fibroids before and after embolization, and to determine whether or not there are pre-embolization MRI characteristics that predict the volume reduction of fibroids. MATERIAL AND METHODS: Uterine fibroid embolization (UFE) was carried out in 28 fibroids of 20 patients, all of whom were symptomatic. The patients were prospectively evaluated with T1-weighted, T2-weighted, and gadolinium-enhanced T1 MRI sequences before and 6 months after embolization. The relationship between the characteristics of MRI signal and contrast-enhancement features of fibroids before the procedure and the change in size of the lesions after treatment was investigated. RESULTS: Before embolization, the mean volume of fibroids was 123 cm3 (8-560 cm3). The decrease rate in fibroid volumes was 44.6% (range 7-70%) 6 months after embolization. Volume reduction was more prominent in fibroids that had a high signal intensity on T2-weighted images and a marked contrast enhancement on T1-weighted images (P < 0.001). However, the volume reduction was insufficient in fibroids with high signal characteristics on pre-contrast T1-weighted images (P < 0.001). CONCLUSION: MRI is an effective method for revealing size and signal changes of fibroids after embolization. MRI signal characteristics and the contrast-enhancement pattern of fibroids before embolization can predict tumor volume reduction after embolization.  相似文献   

18.
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. SUBJECTS AND METHODS: During 38 months, 60 patients (age range, 32-52 years; mean age, 42.5 years) with symptomatic uterine fibroids underwent uterine artery embolization. Only gelatin sponge particles, approximately 500-1000 microm in diameter, were used in all patients. The improvement of clinical symptoms was assessed by questionnaire. Reduction of the largest tumor and uterine volume reductions were assessed using MR imaging. The follow-up period ranged from 1 to 38 months (mean, 10.6 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. MR imaging 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 MR imaging 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.  相似文献   

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