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目的探讨不同栓塞材料在子宫动脉栓塞术(uterine artery embolization,UAE)治疗子宫肌瘤中的应用价值。方法 94例子宫肌瘤患者行选择性双侧子宫动脉插管造影栓塞治疗,随机分为3组,采用不同栓塞材料:真丝线段(natural silk segment,SS)栓塞组32例,聚乙烯醇(polyvinyl alcohol,PVA)栓塞组30例,平阳霉素(pingyangmycin,PLE)碘油乳剂+明胶海绵栓塞组32例。术后随访6个月,观察临床症状改变、肌瘤体积变化、术后不良反应及并发症。结果 3组患者术后贫血、月经量多、压迫症状较术前均有不同程度改善,肌瘤均有不同程度缩小(P<0.05);不良反应及并发症3组间比较差异无统计学意义(P>0.05)。结论 SS和PLE碘油乳剂+明胶海绵颗粒行UAE治疗具有良好的疗效和安全性,可作为PVA的替代物,尤其适用于基层医院。
Objective To investigate the value of different embolic materials in the treatment of uterine fibroids by uterine artery embolization (UAE). Methods Ninety-four patients with uterine fibroids underwent selective bilateral uterine arterial catheterization and embolization. They were randomly divided into three groups. The embolization materials were embolized with natural silk segment (SS) embolization group (32 cases), polyvinyl alcohol alcohol, PVA) embolism group (n = 30), pingyangmycin (PLE) lipiodol emulsion + gelatin sponge embolization group (n = 32) The patients were followed up for 6 months. The changes of clinical symptoms, changes of fibroids volume, postoperative adverse reactions and complications were observed. Results The postoperative anemia, menstrual flow and oppression symptoms of the three groups were all improved to some extent, the fibroids were reduced to varying degrees (P <0.05). There was no significant difference in adverse reactions and complication between the three groups (P> 0.05). Conclusion SS and PLE lipiodol emulsion + gelatin sponge particles UAE treatment has good efficacy and safety, can be used as a substitute for PVA, especially for primary hospital.