张世伟 徐晨<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
杭州市萧山区第一人民医院
Abstract
Objective:To observe the clinical effect of uterine arterial embolism in hysteromyoma treatment.
Methods:18 patients with hysteromyoma were treated by Seldinger method of superselective uterine arterial embolism. PVA was employed to block the blood supply of hysteromyoma.
Results:Theblockage of the blood supply of hysteromyoma can be seeen by angiography.The outcome of 6 month follow-up after embolism manifested thatthe volume of hysteromyoma diminished obviously and the clinical symptoms improved.
Conclusion:Uterine arterial embolism in hysteromyoma treatment is a new mothod which has less trauma and better effect.
Key words:hyseromyoma,Uterine artery,Embolism.
子宫肌瘤是女性生殖系统最常见的良性肿瘤,多发生于育龄妇女。临床以经量过多,经期过长造成贫血,瘤体较大造成压迫症状而就诊。传统治疗方法为手术和激素治疗。但两者均可造成生理或心理创伤。作者于2000年1月开展经皮股动脉穿刺选择性双侧子宫动脉栓塞治疗子宫肌瘤,疗效较好,现场报道如下。
资料与方法
1、一般资料
子宫肌瘤18例均经B超诊断确认。18次子宫动脉栓塞。年龄33-50岁,平均42岁。子宫肌瘤的直径最大6.3cm,最小2.0cm,平均3.5cm。其中肌壁间肌瘤13例,粘膜下肌瘤2例,浆膜下肌瘤3例。血色素均为62~100g/L之间,平均73g/L。患者主要症状月经量过多,月经周期过长。有1例为便秘,里急后重。1例有小腹坠胀感。
2、方法
常规检查血常规,肝、肾功能,心电图。术前3d开始静脉给予广谱抗生素,并作碘过敏试验,马鞍区备皮。术前4h禁食、水。操作方法:全部患者均于经期结束后7~10d行介入治疗。在西门子DSA监视下,采用Seldinger方法,穿刺右股动脉,送入5F导管,超选择进入左侧子宫动脉造影检查。 |