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目的:探讨CT引导下经皮穿刺瘤内注射平阳霉素碘油乳剂(pingyangmycin lipiodol emulsion,PLE)治疗子宫肌瘤的疗效及安全性。方法:对45例症状性子宫肌瘤患者进行CT引导下经皮穿刺瘤内注射PLE治疗,术后随访3～24个月,观察症状缓解情况和副反应的发生情况,并于术后1、3、6、12、24个月分别行B超或CT复查,了解子宫肌瘤大小变化情况,其中2例分别于治疗后4、5周行外科手术,标本送病理检查。结果:本组45例全部治疗成功。39例较完整随访者症状明显改善,肌瘤体积缩小范围在41.2%～95.6%,随访24个月的28例肌瘤体积平均缩小72.4%。副反应主要为下腹部疼痛、发热、恶心、呕吐、阴道少量流血等,无一例发生严重并发症。手术标本病理观察见肌瘤内血管变性闭塞,肌瘤组织大片坏死。结论:CT引导经皮穿刺注射PLE治疗子宫肌瘤是一项安全有效的新技术,具有操作简单、创伤小、恢复快、费用低等优点,值得推广。
Objective: To investigate the efficacy and safety of CT guided percutaneous intratumoral injection of pingyangmycin lipiodol emulsion (PLE) in the treatment of uterine fibroids. Methods: Forty-five patients with symptomatic uterine fibroids underwent CT-guided percutaneous intratumoral injection of PLE. The patients were followed up for 3-24 months and the symptoms and side effects were observed. After 1, 3, 6, 12, 24 months, respectively, B-ultrasound or CT review to understand the size of uterine fibroids, of which 2 cases were treated 4,5 weeks after surgery, the specimens were sent for pathological examination. Results: All the 45 cases in this group were successfully treated. The symptoms of the more complete follow-up in 39 cases were significantly improved, the fibroids shrinking in the range of 41.2% to 95.6%, and the average volume of 28 myometrials in the 24 months follow-up was 72.4%. Side effects mainly abdominal pain, fever, nausea, vomiting, vaginal bleeding, etc., no serious case of serious complications. Pathological observation of surgical specimens showed vascular degeneration occlusion of fibroids, myoma large pieces of necrosis. Conclusion: CT-guided percutaneous puncture and injection of PLE for uterine fibroids is a safe and effective new technique. It has the advantages of simple operation, less trauma, faster recovery and lower cost, which is worth promoting.