分泌期子宫动脉栓塞术治疗弥漫性子宫腺肌病疗效观察

目的探讨分泌期子宫动脉栓塞术的可行性。方法随机将35例弥漫性子宫内膜异位症病人分为两组，A组20例为观察组，于分泌早期或分泌中期行子宫动脉栓塞术（UAE），B组15例作为对照组，于增殖期行UAE。观察两组病人UAE前及UAE后3、6、12个月月经量、痛经程度评分、血红蛋白含量、CA125及子宫体积、子宫动脉搏动指数（PI）、子宫动脉阻力指数（RI）的变化及两组的副作用情况。结果两组病人UAE后，月经量、痛经程度评分、子宫体积、PI、RI于UAE后3个月开始显著下降（P〈0．05～P〈0．01），月经量、痛经程度评分、H、RI于UAE后6个月下降最显著（P〈0．05）；血红蛋白含量、CA125和子宫体积于UAE后12个月缩小最显著（P〈0．05）；A、B两组上述指标组间比较差异无显著性（P〉0．05）。A组20例UAE后全部有阴道出血，B组无阴道出血病人。结论分泌期行子宫动脉栓塞术治疗效果显著，可延长手术时机，但易引起月经提前来潮。

Study on therapeutic effects of uterine artery embolization in treatment of diffused adenomyosis during secretory phase

objective To investigate the Feasibility of uterine arterial enbolization（UAE） in the treatment of Diffuse Adenomyosis during secretory phase Methods Total 35 patients with standard diffuse adenomyosis were enrolled and treated with UAE . 20 cases were treated with UAE during secretory phase as group Ⅰ , the other 15 patients were treated UAE during proliferative phase as groupⅡ. The degree of dysmenorrhea along with amount of menorrhea and uterin volume as well as the level of serum CA125 and pulsatility index （ PI ） ,resistance index（RI） of bilateral uterine arteries were investigated before and after UAE. Results The degree of dysmenorrhea along with amount of menorrbea and uterin volume ,the level of serum CA125 and PI , RI all decreased or declined significantly afer UAE in both two groups （ P 〈 0.05 - P 〈 0.01 ）. The degree of dysmenorrhea and amount of menorrhea decreased most in the 6th month （ P 〈 0.05） , serum CA125 as long as uterin volume decreased most in the 12th month （ P 〈 0.05）. M1 20 cases in group Ⅰhad a early menstruation, but nobody had a early menstruation in group Ⅱ . Conclusion UAE in the treatment of Diffuse Adenomyosis during secretory phase has a significant effect , it can prolong operation time , but may cause the menstruation ahead of time .