介入治疗41例子宫肌瘤继发中重度贫血的研究

目的 研究经皮股动脉穿刺选择性子宫动脉栓塞术（ UAE ）治疗育龄期妇女子宫肌瘤继发中重度贫血的疗效。方法 选择41例诊断为子宫肌瘤继发中重度贫血的患者行UAE治疗，随访6～12个月后观察患者临床症状、贫血改善情况和肌瘤大小。结果 UAE治疗6个月后，患者月经量多、经期延长、下腹坠痛、腰骶部不适、尿频或尿急症状较治疗前显著改善（χ^2分别为15．89、9．71、4．00、4．23、4．10，均P＜0．05），治疗12个月后上述症状亦显著改善（χ^2分别为33．47、16．61、7．41、11．18、8．87，均P＜0．01）。治疗6个月后和12个月后血红蛋白均较治疗前显著升高（t值分别为15．36、18．79，均P＜0．01），红细胞计数均较治疗前显著升高（t值分别为2．45、2．98，均P＜0．05），红细胞压积均较治疗前显著升高（t值分别为7．36、8．41，均P＜0．05）。 UAE治疗6个月后和12个月后肌瘤直径均较治疗前显著缩小（ t值分别为5．42、6．69，均P＜0．05）。结论 UAE治疗育龄期妇女子宫肌瘤失血及继发中重度贫血的患者，能迅速止血、抢救患者生命并纠正贫血以及月经量，改善生活质量，保留子宫并使育龄期妇女有生育机会。

Interventional therapy of secondary mild to severe anaemia in 41 cases of benign uterine myoma

Objective To study the efficacy of percutaneous puncture of femoral artery for selective uterine arterial embolization （ UAE） in treating secondary mild to severe anaemia in child-bearing women with benign uterine tumors .Methods Forty-one cases of uterine benign tumors with secondary mild to severe anaemia underwent UAE , and their clinical symptoms , improving of anemia situation and myoma size were observed after treatment for 6 and 12 months.Results After 6 months of UAE treatment, menorrhagia, menostaxis, ventral sank pain, lumbosacral discomfort , urinary frequency or urgency were significantly improved compared to the situation before treatment （χ^2value was 15.89, 9.71, 4.00, 4.23 and 4.10, respectively,all P〈0.05）, and after 12 months of UAE treatment, the above symptoms were also significantly improved （χ^2value was 33.47, 16.61, 7.41, 11.18 and 8.87, respectively, all P〈0.01）.After 6 and 12 months of UAE treatment the hemoglobin was significantly increased （t value was 15.36 and 18.79, respectively, both P〈0.01）, the red blood cell counts were significantly increased （t value was 2.45 and 2.98, respectively, both P〈0.05）, and the red packed cell volume was also significantly increased （t value was 7.36 and 8.41, respectively, both P 〈0.05）.Myoma diameter after 6 and 12 months of UAE treatment was significantly decreased （t value was 5.42 and 6.69, respectively, both P〈0.05）.Conclusion UAE can help to stop bleeding , cure anaemia and reduce menstrual blood volume for secondary mild to severe anaemia in child -bearing women with benign uterine tumors.The uterus can be further preserved to offer an opportunity of conception .