子宫肌瘤介入治疗的临床观察及护理

目的：研究动脉栓塞治疗子宫肌瘤的临床护理方法。方法：采用Seldinger法动脉栓塞治疗86例子宫肌瘤患者。经股动脉穿刺，将导管选择性插入双侧子宫动脉，经导管注入PVA和平阳霉素，阻断肌瘤血供。护理的主要内容是：充分的术前准备，术后24h严密监测出血情况，及时观察和处理疼痛、呕吐、发热、阴道不规则出血、血管血栓形成等。结果：栓塞双侧子宫动脉后子宫肌瘤血供可完全阻断。治疗后6个 的随访结果；患者月经量及月经周期恢复正常，疼痛明显改善，肌瘤和子宫明显缩小。 临床有效率91％。结论:动脉栓塞治疗子宫肌瘤是一种 创伤小，临床 治疗效果好的新方法。有效的术前、术后护理是保证介入治疗子宫肌瘤的效果的关键。

Nursing of Uterine Myoma Treated with Artery Embolization

Objective To study the clinical nursing methods of embolization of uterine arteries in the treatment of uterine myoma. Methods 86 patients with symptomatic uterine myoma were treated by Seldinger's selective uterine arteries embolization. After a percutaneous femoral arterial puncture, an artery catheter was selectively inserted into bilateral uterine arteries. The poly vinyl alcohol (PVA) and /or pingyangmycin (PYM) were introduced through the catheter to occlude the blood supply of the myoma. The nursing methods included preoperative preparation, observation and management of incision bleeding, the symptoms of pain, vomiting, fever, irregular bleeding of vagina, and blood vessel thrombus within 24 hours after operation. Results The blood supply of uterine myoma was occluded while both uterine arteries were embolized. With a mean 6-month follow-up, the menorrhagia and menstrual cycles returned to normal,and pain was relieved. Ninety-one percent of the patients showed an improvement or stabilization of the symptoms after UAE. Conclusion Selective uterine artery embolization is a new technique for the treatment of uterine myoma with less trauma and has a good clinical outcome. The efficacious preoperative and postoperative nursing is very important to maintain results.