子宫动脉栓塞治疗子宫肌瘤疗效因素分析

目的：探讨子宫动脉栓塞术(uterine artery embolization UAE)对子宫肌瘤的治疗效果，并对影响疗效的因素进行分析。方法：32例症状性子宫肌瘤患者，经超选择性插管双侧子宫动脉内注入PVA微粒栓塞治疗，术后6个月随访复查，观察患者临床症状改善和子宫及肌瘤体积变化情况。结果：UAE术后患者子宫出血症状改善最为明显，栓塞后6个月肌瘤体积平均缩小55.6％，肌壁间和黏膜下肌瘤的临床症状改善和体积缩小较浆膜下肌瘤明显。结论：双侧子宫动脉栓塞治疗子宫肌瘤是一种安全有效的新方法；其疗效与栓塞术后肌瘤血管的重新构建，肌瘤类型，血供状态，子宫动脉单双侧栓塞等多种因素有关。

Influential factors to therapeutic efficacy of uterine artery embolization in the treatment of uterine fibroids]

OBJECTIVE: To investigate the therapeutic efficacy of uterine artery embolization in the treatment of uterine fibroids and to analyse the influential factors to the therapeutic efficacy. METHODS: Thirty-two patients with symptomatic uterine myomas were treated by superselective catheterization and embolization of bilateral uterine arteries using PVA particles. Patients were followed for 6 months after uterine artery embolization. Baseline symptoms and the volume of the fibroids were used as parameters to evaluate the therapeutic efficacy. Influential factors to therapeutic efficacy were analyzed. RESULTS: The clinical symptoms, especially heavy menstrual bleeding, were improved markedly. An average of 55.6% volume reduction of the fibroids was achieved during the 6 month follow-up. The submucosal and intramural location of the myomas reduced more in the volume compared with that of the subserosal location. CONCLUSION: Selective uterine artery embolization is effective for uterine myoma. Influential factors to the therapeutic efficacy may include: postprocedural vascular reconstruction in the fibroid, location of the fibroid, hemodynamic status of the fibroid, and the mode of embolization (unilateral or bilateral).