血管介入栓塞术在妇科良性富血管疾病中的应用及生命质量评价

目的分析介入栓塞术在妇科良性富血管疾病中的应用价值及对患者术后生命质量评价的意义。方法行双侧子宫动脉栓塞术治疗子宫肌瘤、子宫腺肌病共102例（子宫肌瘤55例、子宫腺肌病37例、子宫肌瘤合并子宫腺肌病15例、子宫肌瘤并怀孕2个月1例），产后大出血6例。子宫肌瘤、子宫腺肌病的患者均经B超或MR1等检查明确诊断。分别对于栓塞方法、栓塞剂的配比及注入方法、术后处理等进行了阐述。结果108例患者全部行双侧子宫动脉栓塞术，技术成功率达到100％。术后随访3～12个月。子宫肌瘤55例中，术后3个月超声复查，肌瘤平均缩小42％；12个月复查，肌瘤平均缩小65%。子宫腺肌病37例，有52例术后痛经完全消失，4例明显缓解，1例部分缓解，症状总缓解率为94～95％。产后大出血患者中，除一例因5天后再出血，改用大颗粒PVA外，其余均立即止血。结论子宫动脉栓塞术在治疗子宫肌瘤、子宫腺肌病、产后大出血方面是安全、有效的，而且一般不会影响子宫卵巢的功能，更有利于患者恢复健康，对于妇科良性富血管疾病是一条有效的治疗途径。

Application and Evaluation of Life Quality for Vascular Interventional Embolization in Gynecologic Benign Hypervascular Disease

Objective To analyze the application value and worth of life quality evaluation after operation of vascular interventional embolization in Gynecologic benign hypervascular disease. Methods Bilateral uterine artery embolization was taken for 102 cases of uterine fibroids and adenomyosis （55 uterine fibroids, 37 adenomyosis, 15 uterine fibroids combined with adenomyosis, 1 uterine fibroids combined with 2 months pregnancy）, 6 cases of postpartum hemorrhoea. Diagnosis was made by B-ultrasonic and MR/for patients with uterine fibroids and adenomyosis. The embolization method, match and injection method of emboliaztion agents, postoperative treatment and others were analyzed. Results All 108 cases received bilateral uterine artery embolization, technical successful rate was 100%. Postoperative follow-up was 3-12 months. Fibroids shrink an average of 42% for 55 cases of uterine fibroids after 3 months with ultrasonic inspection, fibroids shrink an average of 65% after 12-month review. 32 cases of dysmenorrhea disappeared completely after operation in 37 cases adenomyosis, 4 patients were relieved, 1 was partial response, overall response rate of symptoms were 94-95%. Only one case was switched to PVA large particles after 3 days for bleeding again in all patients with postpartum hemorrhage, the rest were immediately stopped. Conclusion Uterine artery embolization is safe and effective in the treatment of uterine fibroids, adenomyosis, post-partum hemorrhage, and generally does not affect the function of ovary and uterus, is more conducive for patient back to health, is an effective therapeutic approach for Gynecologic benign hypervascular disease.