子宫动脉栓塞后暂时或永久闭经与卵巢功能的关系

目的对子宫动脉栓塞(UAE)治疗后出现暂时和永久闭经的病例进行分析,研究其与卵巢功能减退或衰竭的关系。方法287例行UAE,10例出现闭经,其中6例为暂时闭经,4例为永久闭经,永久闭经者年龄分别为38、47、48和48岁。观察治疗前后月经改变、血FSH变化,并分析相关因素如术前手术史等。结果暂时闭经患者在术后6个月内月经恢复,血FSH治疗前后差异无显著性;永久闭经患者血FSH治疗前后有显著性差异,治疗后均>20u/L,1例24个月时>100u/L;其中1例,38岁,曾行双侧卵巢手术。结论暂时闭经并不一定表明卵巢功能减退或衰竭。UAE后出现卵巢功能减退或衰竭的概率较低,且多数发生在近绝经期的患者,对曾行双侧卵巢手术的患者行UAE,由于可能引起卵巢早衰,要特别慎重。

Analysis of the relationship between temporary or permanent amenorrhea and ovarian function after uterine artery embolization

Objective To analize the cases of amenorrhea after uterine artery embolization(UAE)and to find out the relationship with ovarian dysfunction or failure. Methods Ten cases out of 287 patients with uterus myoma who underwent UAE were found amenorrhea. Six of them had temporary and 4 had permanent amenorrhea(38, 47, 48 and 48 years old). Preprocedural and postprocedural menstruations, blood FSH levels correlative factors including surgical operations, were observed and analyzed. Results Menstruations of 6 cases with temporary amenorrhea were completely recovered without any significant changes in blood FSH levels, while 4 permanent amenorrhea cases demonstrated significant differences in blood FSH levels after the procedure. Their blood FSH were all > 20 u/L after UAE with one of them > 100 u/L 24 months later and another 38 year-old patient underwent surgical operation of ovaries bilaterally before UAE. Conclusions Temporary amenorrhea may not mean ovarian dysfunction or failure. The probability of ovarian dysfunction or failure after UAE is low, which mainly occur in the peirmenopausal patients. Consideration of the probability of inducing early ovarian failure, caution should be taken for UAE on the patients having ovarian surgery before. (J Intervent Radiol, 2006, 15: 472-475)