达那唑海藻酸钠微球子宫动脉栓塞治疗子宫腺肌症的疗效及安全性探讨

摘要

目的 研究达那唑海藻酸钠微球子宫动脉栓塞术治疗子宫腺肌症的疗效及安全性.方法 对31例子宫腺肌症的患者行达那唑海藻酸钠微球子宫动脉栓塞术,随访月经相关症状变化及子宫和病灶体积改变,并监测不良反应.结果 失访1例(3.2%).28例(93.3%)患者栓塞后月经量较前减少,栓塞前后平均使用卫生巾数量分别为(35.9±19.7)片和(19.8±10.5)片,月经期分别为(6.7±1.9)d和(5.9±2.2)d,16例合并贫血的患者栓塞前后血红蛋白分别为(91±15)g/L和(107±19)g/L,29例痛经患者栓塞前后VAS分级分别为3.3±0.7和 0.9±1.0,痛经症状评分分别为14.4±2.8和 4.4±5.4;栓塞前后子宫体积分别为(266.2±122.7)cm 3和(174.3±88.0)cm 3,平均缩小(35.8±17.6)%,优势腺肌瘤体积分别为(55.2±61.0)cm 3和(40.0±60.4)cm 3,平均缩小(45.2±25.2)%,以上所有统计指标均有显著性差异(P<0.05).主要副反应为栓塞后综合征,栓塞前后卵巢功能测定差异无显著性.恢复月经时间为(24.9±9.7)d,恢复正常生活时间为(3.6±2.0)周,平均住院时间为(2.4±1.2)d.结论 达那唑海藻酸钠微球子宫动脉栓塞治疗子宫腺肌症具有良好的近期疗效及安全性.%Objective:To investigate the efficacy and safety of uterine artery embolizaiton (UAE) with danazol alginate microspheres in patients with adenomyosis.Methods:Uterine artery embolizaiton with danazol alginate microspheres was applied to 31 women with adenomyosis.The changes of menstrual related symptoms, uterine and lesion volum, and side effects were observed.Results:One patient was lost to follow up(3.2%).The menstrual flow was significantly reduced in 28 patients (93.3%)(P<0.05).The average number of sanitary napkins before and after embolization was (35.9±19.7) and (19.8±10.5) respectively.The menstrual period before and after UAE were (6.7±1.9)days and (5.9±2.2)days respectively.Hemoglobin in 16 patients with anemia were significantly increased after UAE [(91±15) vs.(107±19)g/L](P<0.05).Visual analogue pain scale before and after UAE in 29 patients with dysmenorrheal were (3.3±0.7) and (0.9±1.0) before and after embolization respectively.The dysmenorrheal symptom scores were (14.4±2.8) and (4.4±5.4) respectively.Uterine volume [(266.2±122.7)vs.(174.3±88.0)cm 3] were significantly decreased(P<0.05),and average shrink was (35.8±17.6)%.The volume of dominant adenoma [(55.2±61.0)vs.(40.0±60.4)cm 3] was also decreased significantly(P<0.05),and average shrink was (45.2±25.2)%.The major side effect was transient post-embolization syndrome.The ovary function was not significantly altered.The restore menstrual time were (24.9±9.7) days,and the return to normal life time was (3.6±2.0) weeks,and the hospital stay was(2.4±1.2) days.Conclusions:Uterine artery embolization with danazol alginate microspheres in patients with adenomyosis is safe and effective in short term observation.