目的探讨经导管子宫动脉栓塞(TUAE)治疗子宫肌瘤的中期效果及其影响疗效的因素。方法78例子宫肌瘤患者接受TUAE治疗,其中71例伴有经血过多、下腹部或腰腿胀痛、尿频、尿急等不同症状。78例中,壁间肌瘤72例,黏膜下肌瘤6例;多发肌瘤71例,单发肌瘤7例。肌瘤最大直径≤3cm者30例,>3cm者48例。栓塞剂采用碘油平阳霉素乳剂(LPE),其中碘油用量为8～20ml,平阳霉素用量为8～16mg,46例加用明胶海绵颗粒(GSP)栓塞子宫动脉近端。78例中71例行双侧子宫动脉栓塞,7例行单侧栓塞(5例本身为单一子宫动脉供血,2例插管失败)。所有病例栓塞后随访超过3年。结果总的症状改善有效率为97.4%,肌瘤体积1、2、3年平均缩小率分别为59.8%、62.7%和64.6%,子宫体积1、2、3年平均缩小率分别为50.1%、53.9%和55.8%,未见复发病例。肌瘤最大直径≤3cm者,栓塞后肌瘤体积较最大直径>3cm者缩小更明显;黏膜下肌瘤疗效优于壁间肌瘤。加用GSP栓塞,肌瘤缩小更明显;但加大碘油和平阳霉素用量不能增加肌瘤缩小率。双侧栓塞疗效明显优于单侧栓塞。结论TUAE治疗子宫肌瘤具有较好的中期效果,影响其疗效的因素主要包括肌瘤大小和部位、是否加用GSP栓塞以及是否行双侧子宫动脉栓塞。 Objective To investigate the medium-term effect of transcatheter uterine arterial embolism (TUAE) for treating uterine fibroids and its influencing factors. Methods 78 patients with uterine fibroids underwent TUAE treatment. Among them, 71 patients had different symptoms such as excessive menstruation, lower abdomen or lower back pain, urinary frequency and urinary urgency. Of the 78 cases, 72 were intramural fibroids, 6 were submucosal myomas, 71 were multiple myomas, and 7 were single myomas. Fibroids diameter ≤ 3cm in 30 cases,> 3cm in 48 cases. The embolization agent is lipiodol pingyangmycin emulsion (LPE), in which the dosage of lipiodol is 8-20ml, the amount of pingyangmycin is 8-16mg, and 46 cases are treated with gelatin sponge particles (GSP) to embolize the proximal uterine artery. Of the 78 patients, 71 received bilateral uterine artery embolization, and 7 received unilateral embolization (5 were single uterine arterial blood supply, and 2 failed intubation). All cases were followed up for more than 3 years after embolization. Results The overall effective rate of symptom improvement was 97.4%. The mean reduction rates of fibroids in 1, 2 and 3 years were 59.8%, 62.7% and 64.6% respectively. The average shrinkage rates of 1, 2 and 3 years of uterine volume were 50.1% 53.9% and 55.8%, no recurrence cases. The maximum diameter of fibroids ≤ 3cm those who embolized fibroids larger than the largest diameter> 3cm narrowed more obvious; submucosal fibroids better than intramural fibroids. Plus GSP embolization, fibroids shrink more obvious; but increased lipiodol and pingyangmycin dosage can not increase fibroids shrinkage. Bilateral embolization was significantly better than unilateral embolization. Conclusion TUAE treatment of uterine fibroids has a good medium-term results, the factors that affect its efficacy include fibroids size and location, whether to add GSP embolization and whether the implementation of bilateral uterine artery embolization.