两种子宫动脉栓塞方案治疗子宫肌瘤效果比较.docVIP

两种子宫动脉栓塞方案治疗子宫肌瘤效果比较[摘要] 目的 探讨两种子宫动脉栓塞方案治疗子宫肌瘤的临床效果和不良反应。 方法 将已确诊的子宫肌瘤患者78例，随机分为A组和B组，每组各39例。A组以聚乙烯醇颗粒作为栓塞剂，B组以平阳霉素乳剂+明胶海绵作为栓塞剂，两组患者均接受超选择性子宫动脉栓塞术治疗，观察并比较两组患者术前和术后3、6和12个月的临床症状、瘤体改变程度以及月经情况。 结果 两组患者在手术时间、疼痛时间、住院时间等方面无统计学意义，患者术后平均随访时间（13.8±2.1）个月，两组患者在3、6和12个月瘤体缩小率方面无统计学意义（P 0.05），且术后6个月两组患者月经改善情况差异不显著（P 0.05），均无明显不良反应。 结论 平阳霉素乳剂+明胶海绵与聚乙烯醇颗粒用作栓塞剂治疗子宫肌瘤具有相同的临床效果和安全性，且价格较为低廉，值得临床推广。 [关键词] 子宫肌瘤；子宫动脉栓塞；聚乙烯醇；平阳霉素；明胶海绵 [中图分类号] R737.33 [文献标识码] B [文章编号] 1673—9701（2012）26—0033—02 Comparison of two different uterine artery embolization methods in treating patients with uterine fibroids ZHAO Jingqing Department of Gynecological，Dali Peoples Hospital in Yunnan Province，Dali 671000，China [Abstract] 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 fibroids 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 agent，all the patients were given super—selective uterine artery embolization，the clinical symptoms， 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 regression in 3，6 and 12 month after treatment（P 0.05）. Conclusion Pinyangmycin emulsion+gelatin sponge as embolic agent 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 子宫肌瘤是一类最常见的女性生殖系统良性肿瘤，多以月经量过多、月经不调和痛经为主要临床症状，好发于30～50岁的育龄期妇女，发病率在20%～40%左右[1]。虽属良性肿瘤范畴，但常导致妇科非急症出血、腰腹痛、尿频，甚至不孕的发生，严重影响患者的生活质量。传统治疗方法包括子宫切除术、肌瘤剔除术、肌溶解、冷冻和激素等，均具有一定的局限性和弊端[2]。子宫动脉栓塞术（UAE）从问世以来，以其操作简便、创伤小、疗效可靠、保留器官完整性等特点得到了广泛的应用，栓塞是治疗过程中较为重要的环节