兩種子宮動脈栓塞方案治療子宮肌瘤效果比較

1、兩種子宮動脈栓塞方案治療子宮肌瘤效果比較摘要目的 探討兩種子宮動脈栓塞方案治療子宮肌瘤的 臨床效果和不良反應(yīng)。方法 將已確診的子宮肌瘤患者78例，隨機(jī)分為a組和b組，每組各39例。a組以聚乙烯醇 顆粒作為栓塞劑，b組以平陽霉素乳劑+明膠海綿作為栓塞 劑,兩組患者均接受超選擇性子宮動脈栓塞術(shù)治療，觀察并 比較兩組患者術(shù)前和術(shù)后3、6和12個月的臨床癥狀、瘤體 改變程度以及月經(jīng)情況。結(jié)果兩組患者在手術(shù)時間、疼痛 時間、住院時間等方面無統(tǒng)計學(xué)意義，患者術(shù)后平均隨訪時 間(13.8±2.1 )個月，兩組患者在3、6和12個月瘤體縮小 率方面無統(tǒng)計學(xué)意義(p > 0.05 ),且術(shù)后6個

2、月兩組患者月 經(jīng)改善情況差異不顯著(p>0.05),均無明顯不良反應(yīng)。結(jié) 論 平陽霉素乳劑+明膠海綿與聚乙烯醇顆粒用作栓塞劑治 療子宮肌瘤具有相同的臨床效果和安全性，且價格較為低 廉，值得臨床推廣。關(guān)鍵詞子宮肌瘤；子宮動脈栓塞；聚乙烯素；明膠海綿中圖分類號r737.33 文獻(xiàn)標(biāo)識碼b 文章編號16739701 ( 2012 ) 26003302comparison of two different uterine artery embolization methods in treating patients with uterine fibroidszhao jingqingdepar

3、tme nt of gyn ecological , dali people's hospital in yunnan province , dali 671000 , chinaabstract objective to investigate the clinical effect and bad reaction of two different uterine artery embolization methods in treating patients with uterine fibroids. methods all 78 patients with uterine f

4、ibroids were divided into two groups for each 39. patients in group a were given polyvinyl alcohol as embolic agent , others in group b were given pinyangmycin emulsion+ gelatin sponge as embolic age nt , all the patients were give n superselective uterine artery embolization , the clinical symptoms

5、 , change of tumor and menstrual status were compared before and after 3 ,6 and 12 month of treatment. results there was no difference between two groups in the time of surgery , pain , hospitalization and the rate of tumor regressi on in 3 ,6 and 12 month after treatment ( p > 0.05 ) conclusion

6、pinyangmycin emulsion+gelatin sponge as embolic age nt has the same effect as polyvinyl alcohol ,and has a virtue of cheap and safe , deserve to clinical.key words uterine fibroids ; uterine artery embolization ; polyvinyl alcohol ; pinyangmycin emulsion ;polyvinyl alcohol子宮肌瘤是一類最常見的女性生殖系統(tǒng)良性腫瘤，多以月經(jīng)量

7、過多、月經(jīng)不調(diào)和痛經(jīng)為主要臨床癥狀，好發(fā)于3050歲的育齡期婦女，發(fā)病率在20%40%左右口。雖屬良性腫瘤范疇，但常導(dǎo)致婦科非急癥出血、腰腹痛、尿頻，甚 至不孕的發(fā)生，嚴(yán)重影響患者的生活質(zhì)量。傳統(tǒng)治療方法包 括子宮切除術(shù)、肌瘤剔除術(shù)、肌溶解、冷凍和激素等，均具 有一定的局限性和弊端2。子宮動脈栓塞術(shù)(uae )從問世 以來，以其操作簡便、創(chuàng)傷小、療效可靠、保留器官完整性 等特點(diǎn)得到了廣泛的應(yīng)用，栓塞是治療過程中較為重要的環(huán) 節(jié)，目前介入用栓塞材料多種多樣。本研究通過比較兩種栓 塞劑在子宮動脈栓塞術(shù)治療子宮肌瘤中的效果和不良反應(yīng)， 旨在探討其臨床價值和安全性。1資料與方法1.1 一般資料 選擇我院于2009-2011年收治的擇期行子宮動脈栓塞術(shù)的子宮肌瘤患者78例，年齡26-52歲，平均(36.4±7.1 )歲，病史1-6年。其中單發(fā)28例，多發(fā)50例，肌瘤直徑26 cm。術(shù)前均經(jīng)臨床癥狀、婦科檢查和b超、ct或mri確診，并滿足：伴發(fā)月經(jīng)異常、下腹疼痛等臨床癥狀者；無癥狀，但瘤體較大者；無生育要求者；非帶蒂的漿 膜下子宮肌瘤；無栓塞、手術(shù)禁忌證，無嚴(yán)重的肝腎功能 異常者；經(jīng)本人或家屬同意。78例患者隨機(jī)分為pva組 和ple組，每組各39例，兩組患者在年齡、病史、肌瘤數(shù) 目、肌瘤直徑等方面差異無統(tǒng)計學(xué)意義（p > 0.05 b