目的　探讨经导管子宫动脉栓塞 (TUAE)治疗子宫肌瘤的疗效、安全性及栓后切除标本的病理改变与意义。方法　 44例子宫肌瘤患者行经导管子宫动脉注射碘油平阳霉素乳剂 (LPE)加明胶海绵颗粒栓塞治疗 ,其中 7例于栓塞后 1～ 6周行全宫切除或肌瘤剔除术 ,标本送病理检查。另37例随访 1～ 6个月 ,主要观察临床症状改变及肌瘤大小与子宫体积变化。同时 ,通过栓塞后月经观察、卵巢内分泌功能测试、经前诊刮及栓塞后全子宫切除标本病理研究 ,了解栓塞后卵巢功能及正常子宫肌组织的改变。结果　总的症状改善率 91 9% (34 /37) ,其中月经完全恢复正常者占 91 4%(32 /35 ) ,下腹部、腰腿胀痛消失者占 83 3% (2 5 /30 ) ,尿频、尿急等压迫症状消失者占 45 5 7% (5 /11)。栓后 6个月肌瘤体积平均缩小 6 2 4% ,子宫体积平均缩小 5 0 6 %。月经观察无闭经病例发生 ,经前诊刮病理提示子宫内膜呈分泌期改变。卵巢内分泌功能测试栓塞前后变化无明显差异 (P >0 0 5 )。手术标本病理观察 ,碘油仅分布于肌瘤组织 ,栓后 2周肌瘤出现点状坏死 ,3周出现大量片状坏死 ,随着时间延长坏死范围逐渐增大 ,而正常子宫肌层未见坏死。结论　TUAE是一项治疗子宫肌瘤安全、有效的新技术 ;LPE作为栓塞剂 ,对正常子宫肌层不构成损害 Objective To investigate the curative effect and safety of transcatheter uterine arterial embolization (TUAE) in the treatment of uterine fibroids and the pathological changes and significance of posterior resection specimens. Methods 44 cases of uterine fibroids were treated with lipiodol pingyangmycin emulsion (LPE) plus gelatin sponge particles embolization via catheter uterine artery. Seven cases underwent total hysterectomy or myomectomy 1-6 weeks after embolization. The specimens were sent for pathological examination . The other 37 cases were followed up for 1 ~ 6 months, the main observation of clinical symptoms and fibroid size and uterine volume changes. At the same time, through the embolism after menstruation observation, ovarian endocrine function test, pre-curettage and embolization after hysterectomy specimen pathological study to understand the ovarian function and normal uterine muscle tissue changes after embolization. Results The overall rate of symptom improvement was 91 9% (34/37), of which 91 4% (32/35) were completely normal menstruation, 83 3% (2 5/30) lower abdomen and waist and leg pain disappeared, , Urinary frequency, urinary urgency and other symptoms disappeared accounted for 45 57% (5/11). After 6 months of suppository, the volume of fibroids decreased by 62.4% on average, and the average volume of uterus decreased by 56.6%. Menstruation observed without amenorrhea cases, premenstrual curettage pathology prompted changes in the secretory phase of endometrium. Ovarian endocrine function tests before and after embolization no significant difference (P> 0.05). Surgical specimens of the pathological observation, lipiodol only distributed in fibroid tissue, suppository 2 weeks fibroids appear punctate necrosis, 3 weeks a large number of sheet necrosis, necrosis gradually increased with time, but no normal myometrium Necrosis. Conclusion TUAE is a safe and effective new technique for the treatment of uterine fibroids. As an embolic agent, LPE does not damage normal myometrium