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目的研究子宫动脉栓塞术(UAE)治疗子宫腺肌病的临床效果。方法对35例经临床、超声或MRI诊断为子宫腺肌病的患者行UAE,采用Seldinger技术经股动脉穿刺,将导管选择性插入双侧子宫动脉,应用明胶海绵微粒、PVA或KMG与对比剂混匀后在透视下经导管缓慢推注的方法或超液化碘油与平阳霉素(PYM)的混悬乳剂、PVA或KMG、明胶海绵序灌栓塞的方法将子宫动脉栓塞,阻断异位内膜病灶血供,术后定期观察月经量、痛经程度及子宫、病灶体积等变化。结果治疗后对所有患者定期随访,月经量减少至术前的(41.4±6.0)%,月经周期无明显变化;血Hb均恢复至正常水平;21例患者痛经完全缓解消失,10例明显缓解,3例变化不明显,其中1例复发;子宫体积由治疗前的(241.9±56.4)cm~3缩小至治疗后的(98.1±19.2)cm~3。结论子宫动脉栓塞术治疗子宫腺肌病疗效显著,安全性好,患者接受程度高。
Objective To study the clinical effect of uterine artery embolization (UAE) in the treatment of adenomyosis. Methods Thirty-five patients diagnosed as adenomyosis by clinical, ultrasonography or MRI were enrolled in this study. Seldinger technique was used to insert the catheter into bilateral uterine arteries by femoral artery puncture. Gelatin sponge particles, PVA or KMG and contrast agent After mixing evenly in the fluoroscopy through the catheter slowly push the injection method or super-liquefied lipiodol and pingyangmycin (PYM) emulsion, PVA or KMG, gelatin sponge embolization method of uterine artery embolization, blocking the ectopic Endometrial lesions blood supply, regular observation of menstrual flow, dysmenorrhea and uterine, lesion volume and other changes. Results After treatment, all patients were followed up regularly, the amount of menstruation reduced to (41.4 ± 6.0)% before operation, menstrual cycle had no significant change, blood Hb returned to normal level. Twenty-one patients had complete remission and disappearance of dysmenorrhea, No significant changes were observed in 3 cases, of which 1 case relapsed. The uterine volume was reduced from (241.9 ± 56.4) cm ~ 3 before treatment to (98.1 ± 19.2) cm ~ 3 after treatment. Conclusion Uterine artery embolization for the treatment of adenomyosis significant effect, safety, patient acceptance.