子宫动脉栓塞治疗子宫肌瘤的中远期随访研究

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.

Uterine arterial embolization for the treatment of fibroids:middle and long term follow-up study

Objective To evaluate the middle and long term effects of uterine arterial embolization for the treatment of fibroids. Methods Six hundred and thirty-two patients with uterine fibroids were treated with selective uterine arterial embolization and followed up for 6-48 months. Of them, 546 cases were followed up for 6 months, 395 for 12 months, 247 for 24 months, 45 for 36 months, and 9 for 48 months. Color Doppler, clinical effects, changes of estrogen levels, pregnant rate, and recurrence of fibroids were the contents of follow-up. Results The blood supply to the fibroids was as follows: dominantly from unilateral uterine artery (62.97%), from bilateral uterine arteries (33.70%), and partly from ovarian artery (1.58%), and a single unilateral uterine artery was found in 1.74% of the cases. In the 546 cases who were followed up for 6 months, complete disappearance of the fibroids was noted in 70 cases (12.82%), remarkable reduction volume of the fibroids was seen in 367 (67.21%), moderate reduction in 74 (13.55%), and no definite change in 35 (6.41%). There were 16 pregnant cases, and 9 of them gave normal birth. No recurrent fibroids were noted during the follow-up periods for 6-48 mouths. Conclusion Uterine artery embolization for the treatment of fibroids is safe and effective. This methods are more appropriate for treating submucosal fibroids .