血管介入治疗子宫腺肌病的术后受孕观察

目的:探讨子宫动脉栓塞术(UAE)治疗子宫腺肌病不孕症的临床疗效。方法:对10例子宫腺肌病不孕症患者应用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,以混有抗生素及博莱霉素的海藻酸钠微球血管栓塞剂颗粒(直径300~500 um)进行UAE治疗。术后观察临床症状改善及受孕情况。结果:术后10例患者月经量均明显减少,月经周期、经期无明显变化;8例患者术后痛经完全消失,2例明显缓解;术后疼痛评分及评级,比术前明显降低;子宫体积明显缩小;彩超检查显示子宫肌层及病灶内血流明显减少;卵巢内分泌功能无异常改变。栓塞后怀孕6例,2例已顺产。结论:UAE治疗子宫腺肌病的不孕患者微创、有效且安全。

Observing pregnancy after blood vessel interventional therapy for adenomyosis

Objective:To investigate the clinical response of adenomyosis infertility with uterine artery embolization(UAE).Methods:10 patients with adenomyosis infertility were treated by UAE.4.0~5.0F Cobra or 3.0F SP placed into the double uterine arteries.The alginate microcapsule mixed with antibiotic druges and bleomycin were used to embolise the arteries.The effectiveness and pregnancy of patients after treatment were investigated.Results:After the treatment,the mount of periods in 10 patients reduced significantly.Dysmenorrhea completely disappeared in 8 patients,significantly alleviated in 2 patients.The volume of uterine shrunk significantly.The blood flow within the uterine and focus decreased immediately after UAE detect by color Doppler flow imaging.There was no significant difference in ovarian hormones level between pre-and post-embolization.6 patients were pregnant and two gave birth successfully after embolization.Conclusion:UAE is a less-traumatic,safe,effective therapy for adenomyosis infertility.