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目的:对照研究聚乙烯醇颗粒(PVA)与三丙稀微球在子宫肌瘤介入治疗术中的影像学表现、术后临床疗效及不良反应。方法:160例子宫肌瘤患者,随机分为两组,即PVA组和三丙稀微球组,采用Seldinger技术经皮股动脉穿刺,双侧子宫动脉插管,注入混合抗生素的PVA进行栓塞,三丙稀微球组采用三丙稀微球进行栓塞,观察术中影像学表现,术后3个月、6个月、12个月月经恢复情况及术后不良反应,同时B超监测子宫及肌瘤体积大小的变化。结果:术中造影显示三丙稀微球组较PVA组对动脉管腔的栓塞更为完全;两组患者中术前月经量增多者,术后月经量全部恢复正常;两组患者术后3个月、6个月、12个月时肌瘤体积及子宫体积差异均无统计学意义(P>0.05)。术后缺氧缺血性盆腔疼痛为两组的主要不良反应,PVA组疼痛时间、程度明显高于三丙稀微球组,其他方面差异无统计学意义(P>0.05),均无严重并发症发生。结论:使用三丙稀微球栓塞子宫动脉治疗子宫肌瘤的疗效与使用PVA栓塞的疗效相当,三丙稀微球栓塞程度更完全、安全有效、易于操作,是目前子宫肌瘤栓塞的推荐剂型。
OBJECTIVE: To compare the imaging findings of polyvinyl alcohol particles (PVA) and tripropylene glycol microspheres in the interventional treatment of uterine fibroids, the clinical efficacy and adverse reactions after the operation. Methods: One hundred and sixty patients with uterine fibroids were randomly divided into two groups: PVA group and tripropylene glycol microsphere group. Percutaneous femoral artery puncture and bilateral uterine artery cannulation were performed with Seldinger technique. Tripterygium microspheres were embolized with tripropyridium microspheres to observe the intraoperative imaging findings, postoperative 3 months, 6 months, 12 months of menstruation and postoperative adverse reactions, while monitoring the uterus and B ultrasound Fibroids volume changes. Results: The intraoperative angiography showed that the embolization of arterial lumen was more complete in TPA group than in PVA group. The preoperative menstrual volume increased in both groups, and the postoperative menstrual volume returned to normal. The postoperative 3 There was no significant difference in myoma volume and uterine volume between months, 6 months and 12 months (P> 0.05). Postoperative hypoxic-ischemic pelvic pain was the main adverse reaction in both groups. The time and degree of pain in PVA group were significantly higher than those in tripropylene glycol microsphere group, and there was no significant difference in other aspects (P> 0.05) Disease occurs. Conclusions: The efficacy of embolization of uterine artery with triacetate microspheres for treating uterine fibroids is comparable to that of PVA embolization. The degree of embolization of the trimeric microspheres is more complete, safe, effective and easy to operate. It is the recommended dosage form for embolization of uterine fibroids .