子宫动脉栓塞术在治疗子宫肿瘤性病变及出血性疾病中的临床价值

目的探讨子宫动脉栓塞治疗各类子宫恶性肿瘤、子宫肌瘤、出血性疾病的方法,了解其临床效果、不良反应及并发症。方法对30例各类子宫肿瘤和产后大出血患者,通过超选择性双侧或单侧子宫动脉插管,用直径300~500μm的PVA微粒、碘油乳剂和/或明胶海绵条将子宫动脉栓塞。结果30例均栓塞成功,无严重并发症。所有子宫肌瘤病例随访3~12个月,月经恢复正常,贫血病例、血红蛋白升至正常范围,术后6个月肿瘤平均缩小60%;恶性肿瘤病例为Ⅱ期手术提供时机;产后大出血病例用明胶海绵栓塞后,出血立即停止。结论子宫动脉栓塞术是创伤小、保留子宫、并发症少、临床效果好的一种治法。

Clinical value of uterus arterial embolism operation in treating uterus neoplastic disease and hemorrhagic disease

Objective It is to discuss the method of uterus arterial embolism in treating various kinds of uterus malignant tumor,hysteromyoma and hemorrhagic disease,and to comprehend the clinical effect,untoward effect and complication.Methods 30 patients with various kinds of uterus tumor and postpartum hemorrhea were treated with uterus arterial embolism with PVA microparticle whose diameter was 300～500 μm,iodized oil emulsion and/or gelatin sponge stick through super-selectivity unilateral or bilateral uterus arterial cannula.Results The embolism was all successful in 30 cases and no serious complication was taken place.All hysteromyoma patients had been followed up for 3～12 months and the results were that menses returned to normal,hemoglobin rose to normal and the tumor contracted by an average of 60% after operation for six months.Malignant tumor patients were provided juncture for Ⅱ stage operation.Hemorrhage ceased immediately after gelatin sponge embolism in postpartum hemorrhea patients.Conclusion Uterus arterial embolism is a microtrauma and effective method with less complication and can retain uterus.