子宫动脉栓塞术治疗子宫肌瘤9例分析

目的探讨子宫动脉栓塞术（UAE）治疗子宫肌瘤的疗效。方法选择9例子宫肌瘤患者，以Seldinger技术完成单侧股动脉插管，行数字减影血管造影检查，选用3F微导管，插管至双侧子宫动脉并经数字减影血管造影检查证实后，以明胶海绵颗粒栓塞该处血管。结果数字减影血管造影检查发现，子宫肌瘤血液供应丰富。UAE治疗6—12个月后，患者临床症状明显缓解，第6、18个月肌瘤体积缩小，显效率分别为66．7％和88.9％。结论UAE可有效地缩小子宫肌瘤及子宫的体积，并明显改善子宫肌瘤患者的临床症状。     

海藻酸钠微球颗粒子宫动脉栓塞治疗子宫肌瘤的疗效分析

目的:探讨应用海藻酸钠微球颗粒(KMG)行子宫动脉栓塞术治疗子宫肌瘤的疗效。方法:35例子宫肌瘤患者接受子宫动脉栓塞治疗。子宫动脉栓塞方法为经导管双侧子宫动脉注入KMG,栓塞后随访复查,随访时间全部为6个月以上,观察子宫肌瘤的缩小及临床症状改善情况。结果:35例全部完成双侧超选择子宫动脉插管,技术成功率为100%。在有症状的29例中,25例(86.2%)症状有不同程度改善,其中月经症状改善最为显著。至栓塞后6个月时,肌瘤体积平均缩小49.3%,子宫体积平均缩小42.1%,所有患者随访期内肌瘤缩小后未再增大。术后最常见副反应即栓塞后综合征,所有病例随访期内均未出现其他严重副反应或并发症。结论:应用KMG行子宫动脉栓塞术是一种有效、可靠的治疗子宫肌瘤的治疗方法。     

子宫动脉栓塞术81例围术期护理

目的:探讨子宫肌瘤患者行子宫动脉栓塞术介入治疗的围术期护理方法.方法:对81例子宫肌瘤患者行双侧子宫动脉栓塞术,并给予精心围术期护理.结果:本组患者术后肌瘤均不同程度缩小,术后6个月肌瘤体积平均缩小57.5%,术后12个月平均缩小74%,临床症状明显改善.结论:子宫动脉栓塞术微创、安全、疗效显著,充分的术前、术后护理是治疗成功的保障.     

子宫动脉栓塞术治疗子宫肌瘤临床观察

目的研究经导管子宫动脉栓塞术治疗子宫肌瘤的临床效果.方法选择子宫肌瘤患者 30例,采用 Seldinger技术用 5.0 FRH导管行双侧子宫动脉插管,造影确认后注入 PVA栓塞颗粒,阻断肌瘤血液供应.分别于术后 3个月、 6个月观察疗效.结果本组子宫肌瘤均表现为双侧子宫动脉供血,并行一次性两侧栓塞,技术成功率 100%.术后 3～ 6个月, 98.3%月经恢复正常, 92.6%贫血缓解,压迫症状均缓解,肌瘤体积分别缩小 47.92%～ 100%,副反应有缺血性盆腔疼痛,发热和消化道反应,无其他严重并发症.结论子宫动脉栓塞术治疗子宫肌瘤是一种疗效显著的微创治疗方法.     

选择性子宫动脉栓塞术治疗子宫肌瘤的临床观察

目的:探讨选择性子宫动脉栓塞术(UAE)治疗子宫肌瘤的临床效果。方法:采用Seldinger技术行子宫动脉栓塞,治疗36例子宫肌瘤患者。结果:UAE治疗后月经量明显减少至术前的53.7％;血红蛋白由术前的83.3±19.1g/L恢复至121.4±16.3g/L;UAE治疗12个月后子宫和肌瘤平均体积缩小率分别为52.4％及79.0％。结论:选择性子宫动脉栓塞术是子宫肌瘤有效的治疗方法之一。     

PVA微粒子宫动脉栓塞治疗子宫肌瘤(附16例分析)

目的 探讨子宫动脉栓塞术（UAE）治疗子宫肌瘤的技术方法并评价临床疗效。方法 用直径为350－500μm的PVA微粒及自制大小1mm左右的明胶海绵颗粒对16例诊断明确的子宫肌瘤患者进行双侧子宫动脉栓塞，术后随访至少6个月，观察其临床症状及肌瘤大小变化。结果 所有以月经量增多为主要症状的患者术后月经量基本恢复正常；术后子宫体积平均缩小48.9%，肌瘤体积平均缩小49.2%，无严重并发症发生。结论 UAE能有效地消除临床症状，缩小肿瘤体积，是一种较好的治疗手段，易被患者所接受。     

超选择子宫动脉栓塞治疗子宫肌瘤的临床研究

目的 研究超选择子宫动脉栓塞治疗子宫肌瘤的临床疗效及近期、远期并发症。方法 于2001年6月-2005年6月对56例子宫肌瘤患者进行双例子宫肌瘤供血动脉的栓塞治疗，栓塞后定期B超及妇科检查，评价临床疗效，分析近期及远期并发症。结果插管栓塞成功率100％，随访6～48个月，B超示术后1个月肌瘤体积平均缩小25％。随访6个月，7例粘膜下子宫肌瘤患者肌瘤消失，肌瘤体积平均缩小66％，术后12个月肌瘤体积缩小达74％，18个月时肌瘤体积缩小达82．6％。症状缓解率达84．4％-100％，以月经量减少最明显。8、9％患者有卵巢功能衰竭，均为绝经期前后妇女。结论 子宫肌瘤的介入治疗疗效肯定，严重并发症少。对粘膜下子宫肌瘤及有剖宫产、子宫肌瘤剔除术史者尤为适宜。     

子宫动脉栓塞治疗子宫肌瘤49例临床分析

目的 观察经双侧子宫动脉栓塞治疗子宫肌瘤的临床疗效。方法选择子宫肌瘤患者49例，采用seldinger技术行双侧子宫动脉DSA造影插管。确认超选到子宫动脉后，注入PVA栓塞颗粒，阻断肌瘤血液供应，术后3个月、6个月观察疗效。结果子宫动脉栓塞术后，肌瘤及子宫体积缩小约45％-55％，月经恢复正常，贫血改善，其相伴的压迫症状减轻或消失。结论子宫动脉栓塞术治疗子宫肌瘤，方法简单，创伤小，且能完整保留子宫功能，近期疗效明显，是子宫肌瘤新的微创治疗方法。     

经子宫动脉化疗栓塞治疗子宫肌瘤合并输卵管妊娠

目的 探讨经子宫动脉化疗栓塞治疗输卵管妊娠合并子宫肌瘤.方法 对18例子宫肌瘤合并输卵管妊娠患者行超选择子宫动脉造影,经导管向子宫动脉灌注化疗药甲氨喋呤(MTX)及氟尿嘧啶(5-FU)后,明胶海绵颗粒或聚乙烯醇颗粒(PVA)混合平阳霉素栓塞子宫动脉.术后1周、1个月、3个月、6个月、9个月随访临床症状、体征变化,B超和MRI测子宫及肌瘤大小、体积变化,血β人绒毛膜促性腺激素(β-hCG)水平及盆腔包块变化情况.结果 18例中17例获得成功,成功率94.5%,全部患者血β-hCG值6周后可降至正常,12例月经量过多中8例首次月经量被控制.16例月经量恢复正常周期.栓塞后6个月子宫肌瘤体积平均缩小44.5%,9个月肌瘤体积平均缩小55.6%.结论 经子宫动脉介入治疗输卵管妊娠合并子宫肌瘤创伤小、成功率高,能有效制止内出血,扩大了保守治疗的适应证.     

经导管子宫动脉栓塞治疗子宫肌瘤

目的探讨经导管栓塞子宫动脉（TUAE）治疗子宫肌瘤的疗效。方法对38例子宫肌瘤患者分别经导管双侧子宫动脉注入平阳霉素超液化碘油乳剂栓塞，其中23例加用明胶海绵颗粒栓塞，术后3个月、6个月随访，对患者临床表现、肌瘤大小及雌激素水平变化观察对比。结果38例中有临床症状的35例术后3—6个月临床症状均有明显改善，术后3个月和6个月B超或CT复查肌瘤体积分别缩小39．7％、76．1％，FSH、LH、E2手术前后无明显变化。结论TUAE疗效可靠、操作简单、手术安全性高值得临床推广应用。     

Bilateral uterine artery embolisation for myomata: Results,complications and failures

Summary

Uterine artery embolisation (UAE) was carried out on 200 patients who were followed-up by US, MRI, questionnaires and blood tests. Questionnaire data is available from 111 patients and fibroid/uterine volume reduction data from 88 followed-up for a mean of 5/12 months (range 3/12-1 year). The average fibroidhterine volume reduction at 1 year was 69%. US and MRI results were comparable. Menorrhagia improved in 79% of patients; 96% were pleased with the outcome and would recommend it to others. Two serious complications have so far occurred in the 200 patients embolised; in these two patients, infection led to hysterectomy.     

选择性子宫动脉碘油栓塞治疗子宫腺肌病的临床疗效观察

目的 探讨用超液态碘油选择性栓塞子宫动脉治疗子宫腺肌病的价值。方法 采用Seldingers方法经股动脉穿刺，治疗17例子宫腺肌病患者，将导管通过髂内动脉选择性进入子宫动脉，注入超液态碘油和明胶海绵条，阻断子宫供血。结果 血管造影可见双侧子宫动脉增粗，子宫血管走向紊乱，呈网格状，子宫呈球形增大，动脉栓塞后，血流中断，术后6个月随访，子宫体积平均缩小24．1％，76．4％患者痛经消失，23．5％明显缓解，第二个月经周期月经量恢复正常。结论 选择性子宫动脉碘油栓塞治疗子宫腺肌病是一种创伤小，临床效果好的新方法。     

双侧子宫动脉栓塞治疗子宫多发肌瘤的临床应用

目的 探讨双侧子宫动脉栓塞术(UAE)治疗子宫多发肌瘤患者的临床应用价值.方法 对36例子宫多发肌瘤患者均行双侧UAE治疗.术后3个月复查MRI,对手术前及术后3个月肌瘤大小及血供的变化情况进行比较.结果 术后3个月MRI检查示,子宫肌瘤最大径(6.24±0.78)cm较术前(8.36±0.92)cm明显缩小(P＜0.05).子宫肌瘤血液供应减少,69.4％(25/36)患者瘤体内部血流消失.25.0％(6/24)的患者月经量减少,经期较术前规律,75.0％(18/24)的患者月经恢复正常,87.5％(14/16)的患者下腹部坠胀症状缓解,58.3％(7/12)的患者尿频尿急症状好转,60.0％(6/10)的患者贫血症状改善.结论 行双侧UAE治疗子宫多发肌瘤具有良好的临床治疗效果.     

Uterine artery embolization using progressively larger calibrated gelatin sponge particles

Purpose To assess the effectiveness and safety of uterine artery embolization (UAE) using progressively larger calibrated gelatin sponge particles for symptomatic uterine fibroids. Material and methods Thirty patients with symptomatic uterine fibroids underwent UAE. Calibrated gelatin sponge particles were used in all patients, beginning with 355-500?μm particles, progressively increasing to 500-710?μm and finally to 710-1000?μm particles. Changes in tumor, uterine volume, and tumor infarction rate were assessed using pelvic magnetic resonance imaging (MRI). The level of complication, improvement of clinical symptoms, and Uterine Fibroid Symptom and Quality of Life (UFS-QOL) score were assessed. Results MR imaging revealed the mean largest tumor volume reduction was 56.23?±?16.25% at three months and 72.61?±?14.47% at 12 months after the procedure. 100% infarction of the dominant fibroids was 91.27?±?5.02% at three months and 96?±?5.20% at 12 months after the procedure. Menorrhagia improved markedly in all 23 patients. Bulk-related symptoms improved in 12 (92.30%) of 13 patients. The baseline UFS-QOL score was 43.13 and improved to 11.88 (p?<?0.001). No major complications were observed. Conclusion UAE using progressively larger calibrated gelatin sponge particles is an effective and safe treatment for symptomatic uterine fibroids.     

子宫动脉栓塞治疗子宫肌瘤的临床观察

目的探讨子宫动脉栓塞术(UAE)治疗子宫肌瘤的临床疗效。方法对105例根据临床症状、体征、彩色超声诊断的子宫肌瘤患者行UAE治疗,应用4.0~5.0 F Cobra导管或3.0 F微导管完成双侧子宫动脉插管,以混有抗生素的海藻酸钠微球(直径500~700μm)栓塞。术后观察月经量、子宫及肌瘤体积、卵巢功能等变化。结果治疗后平均观察(8.6±1.1)个月经周期,其中98例月经量明显减少(P<0.01),而月经周期、经期无明显变化;子宫与肌瘤体积平均缩小60.6%和83.1%(P<0.01);彩超检查显示子宫肌层及病灶内血流信号明显减少;卵巢内分泌功能无明显变化(P>0.05)。结论UAE治疗子宫肌瘤创伤小、近期疗效显著且安全。     

Transvaginal sonographic appearance of thrombosed uterine arteries after uterine artery embolization: the "white snake" sign

PURPOSE: The aim of this prospective study was to describe the appearance of thrombosed uterine arteries on transvaginal sonography performed after uterine artery embolization (UAE) and to assess the prognostic value of the "white snake" sign with regard to symptomatic outcome at 12 months. METHODS: Patients who underwent UAE from January 1, 1999, to July 31, 2000, for the treatment of symptomatic leiomyomas were included in the study. Transvaginal sonography was performed before and at 3, 6, and 12 months after UAE. Patients graded the severity of their symptoms on a scale from 1 to 5, with 1 being the least and 5 the most severe, before and at 12 months after the procedure. The Wilcoxon rank-sum test was used to determine correlations between severity of symptoms and presence of the white snake sign; a p value of less than 0.05 was considered significant. RESULTS: During the study period, UAE was performed in 19 patients with a mean age of 41 years (range, 32-48 years). UAE was technically successful in all patients. Eighteen patients (95%) reported symptomatic improvement at 12 months: 8 patients (42%) by 4 severity-scale points, 5(26%) by 3 points, and 5 (26%) by 2 points. The 1 patient who did not experience improvement had undergone a hysterectomy at 4 months after the UAE. At the 3-month follow-up, transvaginal sonography demonstrated a tortuous echogenic structure in the adnexa (the white snake sign) in all patients; the finding was still apparent in 10 patients at 6 months but in only 2 patients at 12 months. A direct correlation was found between persistence of the white snake sign and the degree of symptomatic improvement at 6 months (p=0.04) but not at 12 months (p=0.08). CONCLUSIONS: After UAE, a thrombosed uterine artery appears on transvaginal sonography as an echogenic tortuous structure in the adnexa. Persistence of this white snake sign at 6 months after UAE may suggest a more favorable symptomatic outcome.     

子宫动脉栓塞术治疗子宫肌瘤的疗效及其对卵巢功能的影响

目的探讨子宫动脉栓塞术(UAE)治疗子宫肌瘤的疗效及安全性。方法对122例子宫肌瘤患者行UAE治疗,按肌瘤大小分为两组,随访观察肌瘤体积变化与原有症状的改善情况;其中35例监测血中卵巢激素的水平,评价内分泌功能改变。结果117例患者行双侧栓塞,5例行单侧栓塞。110例症状性患者的改善率为87.8%(96例)。栓塞后,小肌瘤组平均肌瘤缩小率要高于大肌瘤组,但两者间无明显统计学差异,且这种差异又有随着时间缩小的趋势。术后无患者出现闭经,栓塞前后激素水平无显著变化。结论行UAE治疗子宫肌瘤,近期疗效明显,且对卵巢内分泌功能无影响。     

顽固性子宫出血介入治疗疗效观察

目的评价子宫动脉栓塞术在各种原因所致的顽固性子宫出血中的治疗效果。方法对16例顽固性子宫出血患者经常规保守治疗无效后行双侧子宫动脉栓塞术。结果 15例成功超选择入子宫动脉,一次双侧子宫动脉栓塞术后12 h内止血成功率93.8%。1例无法超选择而行髂内动脉栓塞,并出现二次出血而行子宫全切术。结论子宫动脉栓塞术能够迅速有效治疗各种原因导致的顽固性子宫出血,是一种避免切除子宫的首选治疗手段。     

Uterine artery embolisation for fibroid disease: Results of a 6 year study

Summary

Uterine myomata are very common Failed treatment frequently leads to major surgery Therefore, non-invasive techniques, such as uterine artery embolisation (UAE) are of great interest and were first reported by Ravina et a1 to treat symptomatic myomata initially scheduled for surgery The objectives of this 6 year study were to evaluate UAE as the only treatment of myomata.

Between 1991 and 1997, 184 women with symptomatic myomata were prospectively enrolled in the study Bilateral, particular UAE was performed with polyvinyl alcohol (PVA, halon) under local anaesthesia and analgesia during a 24 h hospitalisation Women's ages ranged from 21 to 54 years (mean 41) Menorrhagia was present in 93% of cases, pain in 22%, enlarged uterus in 25% Myomata were interstitial (77%), subserous (16%) or submucous (7%) Multiple myomata were common (in 80%, ≥3 myomata) mean myomata diameter 58 mm 157 cases could be evaluated (19 were lost during follow-up and there were eight catheterisation failures) The mean duration of follow-up was 29 months Success with menorrhagia and uterine volume reduction, without subsequent surgery, was observed in 90% of cases Most of the incidents (10%) were benign and observed before 1996, including catheterisation failure and five definitive amenorrhea In seven patients, eight pregnancies were observed These data confirm our previous reports and other studies on the safety and efficacy of UAE as the only treatment of uterine myomata.