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目的研究动脉栓塞治疗子宫肌瘤的疗效。方法选择67例子宫肌瘤用盐酸平阳霉素加超液态碘化油的混合剂选择性子宫动脉栓塞治疗,随访2年,观察其疗效及并发症情况。结果治疗前、治疗后3个月、6个月子宫体积(cm3)和肿瘤体积(cm3)分别为(342.2±24.3)、(186.3±13.5)、(151.8±9.1)和1(23.8±11.7)、(52.6±6.7)、(32.6±4.8),三者间比较差异均有统计学意义(P<0.05);治疗后3个月、6个月瘤体体积分别缩小57.51%和73.67%;月经量多、月经周期延长、贫血、下腹坠胀、尿频尿急的发生率分别为82.09%、10.45%、1.49%和70.15%、8.96%、2.99%和56.72%、2.99%、0.00%和34.33%、2.99%、0.00%和16.42%、0.00%、0.00%,治疗前与治疗后3个月、6个月间比较差异均有统计学意义(P<0.05),治疗后3个月、6个月间比较差异无统计学意义(P>0.05);术后下腹部疼痛59例(占88.06%),发热42例(占62.69%),恶心5例(占7.46%),呕吐3例(占4.48%),穿刺部位血肿1例(占1.49%),均经对症处理后1～7d消失;闭经5例(占7.46%),其中42岁1例,>45岁4例。结论动脉栓塞治疗子宫肌瘤是操作简单、微创、安全、疗效可靠的治疗方法,但须严格选择病例,按照操作程序进行,尽量减少并发症的发生。
Objective To study the curative effect of arterial embolization on uterine fibroids. Methods 67 cases of uterine fibroids were treated by selective uterine arterial embolization with bleomycin hydrochloride and ultra-liquid iodized oil, followed up for 2 years. The curative effect and complications were observed. Results Before treatment, the uterine volume (cm3) and tumor volume (cm3) at 3 months and 6 months after treatment were (342.2 ± 24.3), (186.3 ± 13.5), (151.8 ± 9.1) and 1 (23.8 ± 11.7) , (52.6 ± 6.7) and (32.6 ± 4.8) respectively, with significant difference between the three groups (P <0.05). After 3 months and 6 months of treatment, the tumor volume was reduced by 57.51% and 73.67% The incidence of anemia, abdominal bulge and urinary frequency were 82.09%, 10.45%, 1.49% and 70.15%, 8.96%, 2.99% and 56.72%, 2.99%, 0.00% and 34.33% , 2.99%, 0.00% and 16.42%, 0.00% and 0.00%, respectively. There were significant differences between before treatment and three months and six months after treatment (P <0.05) There were no significant differences between the two groups (P> 0.05). There were 59 cases of lower abdominal pain (88.06%), 42 cases of fever (62.69%), 5 cases of nausea (7.46%) and 3 cases of vomiting 4.48%). One patient (1.49%) had puncture site hematoma which disappeared 1 ~ 7 days after symptomatic treatment. Amenorrhea was found in 5 cases (7.46%), of which 42 cases were in one case and 4 cases were> 45 years old. Conclusions Arterial embolization is a simple, minimally invasive, safe and reliable curative treatment of uterine fibroids. However, strict selection of cases and follow-up procedures should be done to minimize the occurrence of complications.