选择性子宫动脉栓塞治疗症状性子宫肌瘤

目的：探讨和评价选择性子宫动脉栓塞治疗症状性子宫肌瘤的有效性和安全性，材料和方法：对12例症状性子宫肌瘤患者进行选择性子宫动脉栓塞治疗，于术后3－8天，1月、3－8月随访，观察瘤体内栓塞沉积情况，坏死范围，肿瘤体积变化及 症状缓解情况。结果：所有病例均栓塞成功，术后3－8天CT扫描示：栓塞剂在肌瘤内沉积良好，1月，瘤体内出现明显坏死；3－8月，肌瘤体积缩小大于60％者21例（65．63％），30－60％者7例（21．87％），小于30％者2例（6．25％），1例无效，1例术后15天行子宫切除，随访期内28例临床症状完全消失，2例症状减轻，1例症状无变化，结论：选择性子宫动脉栓塞治疗症状性子宫肌瘤疗效确切，术程安全，远期效果及复发率需进一步观察。     

子宫动脉栓塞治疗子宫肌瘤

子宫肌瘤是女性生殖系统最常见的良性肿瘤;多发生在30～50岁;以月经过多、继发贫血和子宫肿块为主要临床表现;并有0.4～1％的恶变率。治疗上以激素疗法、子宫肌瘤剔除术、子宫次全切除术、子宫全切除术及子宫肌瘤溶解术为主;但这些方法常造成病人生理、心理的负面影响及治疗效果不甚理想,如子宫肌瘤剔除术可有20～25％的复发率而需行第二次手术,以及手术时遗留微小肌瘤并于术后在卵巢激素作用下长大出现症状;子宫次全切除术则可有0.4％～1.9％的子宫颈残端癌的患病率;全子宫切除术由于子宫被切除而造成病人月经的人为中止和心理的改     

子宫动脉栓塞治疗子宫肌瘤

子宫肌瘤是育龄妇女最常见的良性肿瘤,对其治疗主要以手术切除为主,部分患者采用激素做内分泌治疗。但手术治疗创伤大,并发症多,恢复慢,少数患者同时还要切除子宫等组织,影响患者生活质量,内分泌治疗会引起患者生理异常。我们经过对9例子宫肌瘤患者做选择性子宫动脉栓塞,取得了一定的疗效。1　资料与方法11　本组病例年龄在35～50岁。肌瘤直径在5ｃｍ～6ｃｍ占7例,最小的3ｃｍ,最大的8ｃｍ。临床症状有月经过多,经期延长,周期过频。并由此引起贫血,下腹坠胀酸痛。较大的肌瘤引起压迫症状导致尿频、排尿困难、便秘等。经彩色多普勒和Ｂ超检查…     

子宫动脉栓塞治疗子宫肌瘤36例

目的对子宫动脉栓塞治疗子宫肌瘤进行研究,了解此方法疗效、副反应及并发症,探索子宫肌瘤新的治疗方法。方法对36例子宫肌瘤患者进行子宫动脉栓塞,随访复查瘤体缩小及出血症状、贫血改善的情况。结果随诊24个月,瘤体缩小23.1%～87.5%。所有子宫出血病例,月经恢复正常;贫血病例,血红蛋白上升82.0%;无严重并发症发生。结论双侧子宫动脉栓塞治疗子宫肌瘤是一种创伤小,临床效果好的新方法。更远期的效果尚待继续观察。     

子宫动脉栓塞治疗子宫肌瘤的临床研究

我院2000年4月～2001年12月对29例子宫肌瘤患者用聚乙烯醇(PVA)颗粒+平阳霉素+超液化碘油乳剂进行选择性双侧子宫肌瘤供血动脉进行栓塞治疗,效果显著,现报告如下.     

子宫动脉栓塞术治疗子宫肌瘤

子宫肌瘤是女性生殖系统最常见的良性肿瘤,育龄期妇女的发病率约为 ２０％－２５％,在４０岁以上女性中约占４０％。子宫肌瘤是来源于平滑肌的良性肿瘤,病因不明。通常认为与雌激素、生长激素、黄体酮有关,尤其与雌激素的分泌异常有关。大多数子宫肌瘤不引起症状,仅有１０％～２０％的患者有症状,需要医疗。常见症状包括月经不调、经血过多、盆腔疼痛、下腹坠胀感,部分病人还可导致不孕和流产。传统的治疗方法主要有激素治疗、肌瘤摘除术、冷冻子宫切除术等,但多有一些缺陷。 子宫动脉栓塞术治疗子宫肌瘤是近年发展的新方法,是指用…     

子宫动脉栓塞治疗子宫肌瘤21例效果观察

子宫肌瘤是女性生殖器官中最常见的良性肿瘤，其发生率大约占育龄妇女的20％～25％，约占女性良性肿瘤的52％。临床上多采用子宫切除或肌瘤摘除术，手术创伤大、恢复慢。1995年子宫动脉栓塞首次被认为是治疗子宫肌瘤的有效方法，国内1998年始有些大医院也相继采用子宫动脉栓塞治疗子宫肌瘤。我院自2003年7月～2006年10月采用经皮经血管超选择性子宫动脉栓塞治疗子宫肌瘤21例，均获得了显著疗效。现报告如下。     

子宫肌瘤的子宫动脉栓塞治疗

目的 研究子宫肌瘤的动脉栓塞治疗的临床应用。方法 采用Seldinger方法超选择性子宫动脉栓塞治疗18例子宫肌瘤患，用PVA阻断瘤体血供。结果 血管造影可见肌瘤血供阻断。术后6个月随访结果表明肌瘤瘤体明显缩小．临床症状改善。结论 子宫动脉栓塞治疗子宫肌瘤是一种创伤小的新方法。     

静脉自控镇痛泵在子宫肌瘤栓塞治疗中的应用

目的 总结在子宫动脉栓塞治疗子宫肌瘤时,使用静脉自控镇痛泵对预防术中及术后疼痛及介入相关指标临床疗效和经验.方法 109例子宫肌瘤行双侧子宫动脉栓塞的病例,采用碘油平阳霉素乳剂加明胶海绵颗粒为栓塞材料,其中80例使用静脉自控镇痛泵,另29例使用利多卡因100 mg（2 ml）加生理盐水4.0 ml稀释成6.0 ml,患者疼痛不适时由导管注入,必要时加肌肉注射度冷丁50 mg.记录栓塞治疗中及治疗后患者急性缺血反应和症状.结果 与未使用静脉自控镇痛泵的病例相比,使用静脉自控镇痛泵患者术中及术后疼痛症状明显减轻,镇痛效果达85 %（68/80例）,与常规镇痛存在显著差异性.结论 子宫动脉栓塞治疗子宫肌瘤时使用静脉自控镇痛泵可以显著减轻常规栓塞治疗时的疼痛症状,是一种操作简单,效果好的方法,可推进子宫肌瘤动脉栓塞术的广泛应用.     

子宫肌瘤介入栓塞治疗34例分析

目的 评价经导管子宫动脉栓塞治疗子宫肌瘤的疗效。方法 34例子宫肌瘤患均采用超选择性双侧子宫动脉插管方法，注射聚乙烯醇（PVA）和明胶海绵栓塞。结果 所有病例随访1－15个月（平均6个月），总的症状改善率91．2％（31／34），表现为月经增多症状均有不同程度改善，下腹部胀痛消失，栓塞后肌瘤均有缩小，B提示瘤体缩小1／3或以上达79．4％（27／34）。结论 子宫动脉栓塞治疗子宫肌瘤病是一种安全、有效的治疗方法。     

Fertility after uterine artery embolization: a review

Uterine artery embolization (UAE) research has largely been focused on women over 40 years, yet women of reproductive age undergo UAE without any increased morbidity. Some physicians refrain from recommending UAE to women in this age group because of some research findings showing a negative effect on fertility. This review presents a comprehensive discussion of the fertility potential of women undergoing UAE, in terms of pregnancy rates and complications as well as ovarian function and reserve. Findings indicate many benefits for women desiring fertility who undergo UAE over traditional myomectomy.     

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.     

Acquisition of endovascular skills for uterine artery embolization using a simulator

This study addresses endovascular training using simulators for uterine artery embolization. A review of endovascular skill training for surgeons using simulators was performed. Surgeons possess varying levels of proficiency in endovascular techniques. A simulator will improve endovascular skills in the following areas: C-arm image intensifier use, catheter selection and manipulation, understanding of the pelvic anatomy, and technique of embolization. Surgeons may gain realistic experience on the simulator prior to entry into the cath lab or procedure room. Using a simulator, surgeons can learn valuable endovascular skills necessary for successful performance of uterine artery embolization.     

MRI对子宫动脉栓塞术治疗子宫肌瘤的价值

目的 观察经动脉导管子宫动脉栓塞术(UAE)治疗前后子宫肌瘤MRI表现,评估MRI对UAE治疗子宫肌瘤的价值。 方法 对40例接受UAE治疗的子宫肌瘤患者,分别于UAE治疗前及治疗后行MR检查,观察子宫肌瘤UAE前后的MRI信号及体积的变化情况。 结果 40例患者中共发现75个子宫肌瘤,其中肌壁间型60个(80.0%),浆膜下型12个(16.0%),黏膜下型3个(4.0%)。UAE治疗前,75个子宫肌瘤中56个(74.7%)T2^*     

经导管子宫动脉栓塞治疗子宫肌瘤的疗效及安全性评价

目的 探讨经导管子宫动脉椎塞（TUAE）治疗子宫肌瘤的疗效及安全性。方法 38例子宫肌瘤患者行经导管子宫动脉注射碘油平阳霉素乳剂栓塞治疗,其中5例于栓塞后1－3周行全宫切除或肌瘤剔除术,标本送病栓。另33例随访3－6个月,主要观察症状改善及肌瘤大小与子宫体积变化。结果 总的症状改善率90.6%（39／32％）,其中月经完全恢复正常点90.3%（28／31）,下腹部、腰腿胀痛消失占83.3%（25／30）,尿频、尿急等压迫症状消失占45.57%（5／11）。肌瘤体积平均缩小61.3%,子宫体积平均缩小50.6%,手术标本病理观察,碘油仅分布于肌瘤组织,栓后2周肌瘤出现点状坏死,3周出现大量片状坏死,而正常子宫肌组织未见异常。TUAE后未见严重并发症发生。结论 TAUE治疗子宫肌瘤具有明显的近期疗效,而且是一项安全的治疗方法。     

不同大小聚乙烯醇颗粒在子宫腺肌症介入治疗中的临床疗效

目的评价不同大小聚乙烯醇(PVA)颗粒在子宫腺肌症介入治疗中的临床疗效。方法回顾性分析152例经子宫动脉栓塞术治疗的子宫腺肌症患者,根据PVA颗粒的大小随机分为A(350⁵00μm)、B(500500μm)、B(500⁷10μm)两组,每组病例76例,比较两组病例经子宫动脉栓塞术治疗后临床症状缓解程度及术后不良反应的差异。结果在痛经减轻、子宫体积变化方面两组比较,术后3个月差异有统计学意义(P<0.05),术后6个月两组比较无统计学差异(P>0.05),术后1年两组痛经减轻程度有统计学差异(P<0.05),而子宫体积方面两组比较无统计学差异(P>0.05),1年后两组病例完全缓解率均达到80%以上,无统计学差异,术后不良反应两组比较有统计学差异(P<0.05),A组不良反应更为显著,而两组在月经期及月经量改变、总有效率比较无统计学差异(P>0.05)。结论虽然两组临床效果半年后即达到相似,但A组术后不良反应疼痛更为严重,故从中长期效果及安全性来看,B组似乎更占优势。     

Uterine artery embolization as a treatment for symptomatic uterine fibroids: a review of literature and case report

PURPOSE: To provide a case presentation and review of the literature on uterine artery embolization (UAE) as a treatment alternative for symptomatic uterine fibroids and to guide the nurse practitioner (NP) in patient selection, education, and periprocedural management of patients undergoing this procedure. DATA SOURCES: Research articles, clinical articles, and case studies pertaining to UAE. CONCLUSIONS: UAE is a safe, well tolerated, and effective nonsurgical treatment option for symptomatic uterine fibroids. This uterus-sparing procedure has low complication rates with excellent clinical outcomes and high patient satisfaction rates. The majority of women who undergo UAE report marked reduction in the severity of fibroid specific symptoms and significant improvement in their quality of life. Uterine fibroids are common in women and often produce symptoms that have a negative impact on quality of life. IMPLICATIONS FOR PRACTICE: The NP is instrumental in identifying which patients may be appropriate candidates for UAE, educating them about the risks and benefits of the procedure, and managing these patients before and after the procedure.     

Efficacy of patient-controlled hydromorphone analgesia in those undergoing uterine fibroid artery embolization via the right radial artery

ObjectiveTo evaluate the efficacy and safety of patient-controlled analgesia (PCA) with hydromorphone as perioperative analgesia during uterine artery embolization (UAE) via the right radial artery.Patients and methodsA total of 33 patients with uterine fibroids, who underwent UAE at the authors’ hospital between June 2021 and March 2022, were selected. Hydromorphone (10 ​mg) was dispensed into a 100 ​ml PCA pump with normal saline. Pump administration was initiated 15 ​min before the start of the procedure, and the intraoperative dose was adjusted according to patient pain level. A numerical rating scale was used to evaluate pain immediately after embolization, 5 ​min after embolization, at the end of the procedure, and 6, 12, 24, 48, and 72 ​h after the procedure. Side effects were also observed.ResultsThirty-three patients underwent uterine artery embolization via the right radial artery. Patient pain was well controlled at all time points surveyed, and patients reported satisfaction with analgesia. The median length of hospital stay was 5 days. There were 7 cases of adverse reactions, but no serious side effects were observed.ConclusionPatients reported positive experiences with arterial embolization of uterine fibroids via the right radial artery. Hydromorphone PCA effectively controlled pain. The PCA pump is easy to operate, has a low incidence of adverse reactions, and offers economic benefits at the patient and institutional levels.