盐酸法舒地尔在妇科介入治疗中的应用

目的探讨经子宫动脉介入诊治过程中子宫动脉痉挛的发生率,评估盐酸法舒地尔对解除子宫动脉痉挛的有效性和安全性。方法 2007年07月至2011年11月87例接受经子宫动脉造影和介入治疗患者,在子宫动脉插管造影、灌注化疗及血管栓塞过程中发生子宫动脉痉挛,并根据子宫动脉痉挛程度分为轻度、中度、重度、顽固性4类。对于中、重度、顽固性子宫动脉痉挛者给予导管内缓慢推注盐酸法舒地尔5 mg,观察子宫动脉痉挛解除时间,记录推注前后血压、心率变化情况,同时观察患者有无头晕、头痛、视物模糊、消化系统及过敏等不良反应。结果 87例中有65例(75%)发生不同程度子宫动脉痉挛,其中轻度5例、中度16例、重度4I例、顽固性3例。给中度以上子宫动脉痉挛者推注5 mg盐酸法舒地尔后,5 min内均能迅速解除痉挛,成功实施介入诊治。推注盐酸法舒地尔前后血压、心率差异均无统计学意义(P>0.05),1例患者发生低血压、颜面潮红,心慌。结论盐酸法舒地尔可安全、有效、迅速缓解子宫动脉痉挛。

The application of fasudil hydrochloride in gynecological interventional treatment

Objective To investigate the incidence of uterine artery spasm occurred during uterine arterial interventional diagnosis and treatment,and to evaluate the safety and effectiveness of fasudil hydrochloride in relieving the uterine artery spasm.Methods During the period from July 2007 to Nov. 2011,a total of 87 patients received uterine artery angiography and interventional treatment.During the performance of angiography,catheterization,infusion chemotherapy and arterial embolization uterine artery spasm occurred in 65 patients.According to the severity of uterine artery spasm,the patients were divided into four categories:mild,moderate,severe and intractable.For patients with moderate,severe or intractable uterine artery spasm,slow injection of hydrochloric acid fasudil 5 mg through the catheter was carried out. The spasm-relieving time,the changes of blood pressure and heart rate were recorded,and the patients were kept under observation for the occurrence of adverse effects such as dizziness,headache,blurred vision, digestive and allergic reactions,etc.Results Of the 87 patients,uterine artery spasm occurred in 65 (75%),including mild(n = 5),moderate(n = 16),severe(n = 41) and intractable spasm(n = 3).After the injection of hydrochloric acid fasudil 5mg the uterine artery spasm was relieved within five minutes.The therapeutic interventional procedure was thus able to be accomplished.After the injection of hydrochloric acid fasudil both the blood pressure and heart rate showed no significant changes when compared with those determined before the injection(P > 0.05).One patient experienced transient hypotension,facial flushing and palpitation.Conclusion The use of hydrochloric acid fasudil can safely,effectively and quickly relieve the uterine artery spasm occurred during the performance of gynecological interventional management.