摘要
目的观察不同子宫动脉介入栓塞(UAE)方案治疗子宫肌瘤的疗效及对子宫血供、卵巢功能的影响。方法回顾性分析2016年5月至2019年5月于丽水市人民医院和杭州市第一人民医院接受子宫动脉介入栓塞治疗的80例子宫肌瘤患者的临床资料,按照治疗方法分为平阳霉素碘化油乳剂(PLE)组39例,聚乙烯醇(PVA)组41例。比较两组临床疗效、超声影像学指标、子宫肌瘤内部血供[平均流速(Vm)、收缩期峰值血流速度(Vs)、最粗供血动脉管径、阻力指数(RI)]、卵巢功能[促卵泡生长激素(FSH)、雌二醇(E2)、孕酮(P)、促黄体生成素(LH)]水平、术后6个月内复发率及术后综合征。结果术后3个月,PVA组总有效率为92.68%,PLE组为89.74%,差异无统计学意义(P>0.05);术后6个月,两组患者子宫体积、子宫肌瘤体积较术前均显著下降(t值分别为59.216、22.361、46.388、22.393,均P<0.05),而两组术后比较差异无统计学意义(均P>0.05);术后6个月,两组Vm、Vs、最粗供血动脉管径水平均较术前显著下降(t值分别为15.022、26.973、16.932、14.620、26.535、12.462,均P<0.05),而两组RI水平均较术前显著上升(t值分别为39.333、39.254,均P<0.05),两组术后Vm、Vs、最粗供血动脉管径、RI水平比较差异均无统计学意义(均P>0.05);术后6个月,两组患者FSH、E2、P、LH水平较术前比较均无明显差异(均P>0.05),且两组术后比较差异无统计学意义(均P>0.05);PVA组术后6个月复发率及术后综合征总发生率均明显低于PLE组(χ^(2)值分别为4.782、7.179,均P<0.05),而两组盆腔感染、闭经、恶心、呕吐、发热、下腹坠痛等术后综合征发生率单独比较均无统计学意义(均P>0.05)。结论PLE或PVA作为介入治疗的插管栓塞材料均可有效改善子宫肌瘤患者子宫体积、子宫肌瘤体积,促进子宫肌瘤内部血供的恢复,并对卵巢功能无明显影响。其中PVA材料术后综合征总发生率及短期内复发率更�
Objective To observe and compare efficacy of different uterine artery interventional embolization(UAE)regimens in treatment of uterine fibroids and their effects on uterine blood supply and ovarian function.Methods The clinical data of 80 patients with uterine fibroids who received UAE treatment in Lishui Municipal People’s Hospital and The Affilated First Hangzhou People’s Hospital,School of Medicine,Zhejiang University from May 2016 to May 2019 were retrospectively analyzed.The patients were divided into pingyangmycin-lipiodl emulsion(PLE)group(39 cases)and polyvinyl alcohol(PVA)group(41 cases)according to embolizing agents given.The clinical efficacy,ultrasound imaging indexes,blood supply inside uterine fibroids[mean flow rate(Vm),peak systolic blood velocity(Vs),diameter of the thickest blood supply artery,resistance index(RI)]and ovarian function[follicle stimulating hormone(FSH),estradiol(E2),progesterone(P),luteinizing hormone(LH)]and recurrence rate at 6 months after surgery and postoperative syndromes were compared between the two groups.Results At 3 months after surgery,the total effective rate was 92.68% in PVA group and 89.74% in PLE group(P>0.05),there was no significant difference between the two groups(P>0.05).At 6 months after surgery,the uterine volume and volume of uterine fibroids of the patients in the two groups were significantly decreased compared with those before surgery(t=59.216,22.361,46.388 and 22.393,respectively,all P<0.05),but there were no statistically significant differences between the two groups after surgery(both P>0.05).At 6 months after surgery,the Vm,Vs and diameter of the thickest blood supply artery of the patients in the two groups were significantly decreased compared with those before surgery(t=15.022,26.973,16.932,14.620,26.535,12.462 respectively,all P<0.05),but the RI of the patients in the two groups was significantly increased compared with that before surgery(t=39.333 and 39.254 respectively,both P<0.05),and there were no statistically significant difference
作者
余伟杰
蓝勇
周丽
刘伟
YU Weijie;LAN Yong;ZHOU Li;LIU Wei(Department of Interventional Treatment,Lishui Municipal People's Hospital,Zhejiang Lishui 323000,China;Department of Gynecology,The Affilated First Hangzhou People's Hospital,School of Medicine,Zhejiang University Zhejiang Hangzhou 310006,China)
出处
《中国妇幼健康研究》
2021年第2期247-253,共7页
Chinese Journal of Woman and Child Health Research
关键词
子宫动脉介入栓塞
子宫肌瘤
子宫血供
卵巢功能
平阳霉素碘化油乳剂
聚乙烯醇
uterine artery interventional embolization
uterine fibroids
uterine blood supply
ovarian function
pingyangmycin-lipiodl emulsion
polyvinyl alcohol
