目的 对比评价聚乙烯醇颗粒(PVA)与平阳霉素碘油乳剂(PLE)两种材料在行子宫动脉栓塞治疗子宫肌瘤合并子宫腺肌病的临床疗效.方法 对28例根据临床表现、超声及DSA造影诊断为子宫肌瘤合并子宫腺肌病的患者随机分为A、B两组,A组14人应用PVA行子宫动脉栓塞术(UAE);B组14人应用PLE行栓塞术.28例患者均应用微导管行超选择性子宫动脉插管并注射栓塞材料.术后随访6~30个月观察病人的痛经程度,月经量及子宫病灶的体积变化.结果 栓塞技术成功率100%.A组8例、B组10例术后3月痛经消失;A组6例、B组4例治疗后症状明显缓解.术后5个月痛经消失.A、B组患者术后6个月子宫体积平均缩小41.83%,43.59%.术后6个月A组、B组肌瘤体积平均缩小分别为51.63%,52.9%.结论 PVA与PLE两种材料在子宫动脉栓塞治疗子宫肌瘤合并子宫腺肌病的临床疗效对比观察中无明显差别,无统计学意义(P>0.05).
Objective To investigate the clinical effect of uterine arterial embolization with polyvinyl alcohol (PVA) and pingyangmycin-lipiodol emulsion (PLE) in the uterine leiomyoma and adenomyosis. Methods Twenty-eight patients with leiomyoma and adenomyosis diagnosed by ultrasound, DSA and clinical examination were divided into 2 groups. PVA particles and PLE were respectively used in 14 patients of each group. Microcatheters were applied in all cases. Followed-up period was 6 to 30 months. Results Technical success was achieved in all cases. Dysmenorrhea was disappeared in 8 cases of group A and 10 cases of group B 3 months after UAE, in 6 cases of group A and 4 cases of group B was dissolved at 5 months after UAE. The mean uterine volume reduction was 41.83 % and 43.59 % respectively at 6 months follow-up. The fibroid volume reduction in Group A and Group B was 51.63% and 52.9% respectively at 6 months follow-up. No severe complications happened. Conclusion Therapeutic effect of uterine arterial embolization with PVA or LPE has no significant difference in uterine adenomyosis and leiomyoma.