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目的:分析获得性子宫动静脉畸形(uterine arteriovenous malformation,UAVM)的临床特点、诊断及治疗方法。方法:入选2014年1月至2021年3月首都医科大学附属北京友谊医院影像学诊断为UAVM 16例患者的临床资料,进行回顾性分析。观察分析患者的一般资料:年龄、孕产次等;辅助检查情况:人绒毛膜促性腺激素(human chorionic gonadotropin,hCG)、B超、CT血管造影(CT angiography,CTA)、磁共振、数字减影血管造影(digital subtraction angiography,DSA)、病灶直径、阻力指数(resistance index,RI)、收缩期峰值血流速度(peak systolic velocity,PSV)、治疗方案及术后病理特点等。结果:16例患者中hCG阴性10例,阳性6例。两者第1次异常出血时间分别为(43.4±36.4)d与(16.0±9.0)d;再住院时间为(63.3±54.4)d与(48.3±54.0)d;其中6例大量出血患者均为hCG阴性。16例患者超声均提示宫腔见血流丰富的混合回声光团,行磁共振检查14例也提示宫腔内或宫壁异常信号;6例DSA检查可见团块状染色,静脉提前显影,2例可见造影剂外溢,5例CTA结论与DSA相符。治疗中行子宫动脉栓塞5例,其中2例为大出血急诊行双侧子宫动脉栓塞、3例为预防性栓塞。4例在栓塞后行宫腔镜,1例因宫腔内无明显组织物行球囊压迫止血。未行子宫动脉栓塞者实施宫腔镜手术10例,米非司酮联合米索前列醇治疗未刮宫1例。经手术治疗的15例中14例病理学可见退变滋养细胞或绒毛组织。随访中1例子宫动脉栓塞后患者术后主诉月经减少,超声考虑宫腔粘连可能。结论:妊娠终止后应加强影像学检查,警惕UAVM的发生,一旦诊断应尽早开始医疗干预以减少出血。妊娠相关UAVM尚无标准化治疗,需根据患者的临床表现、出血情况、病灶位置以及是否有生育要求等因素综合考虑治疗方案。“,”Objective:To analyze the clinical characteristics, diagnosis and treatment of acquired uterine arteriovenous malformation (UAVM).Methods:The clinical data of 16 patients with diagnosis of UAVM from January 2014 to March 2021 in Beijing Friendship Hospital, Capital Medical University were enrolled in this retrospective study. The general data of patients were observed and analyzed: age, pregnancy and childbirth, etc. Auxiliary examinations: human chorionic gonadotropin (hCG), B-ultrasound, CT angiography (CTA), magnetic resonance (MRI), digital subtraction angiography (DSA), lesion diameter, resistance index (RI), peak systolic velocity (PSV), treatment and postoperative pathology.Result:Among the 16 patients, hCG was negative in 10 cases and positive in 6 cases. The first abnormal bleeding time was (43.4±36.4) days and (16.0±9.0) days, respectively. The rehospitalization time was (63.3±54.4) days and (48.3±54.0) days. Six patients with massive bleeding were HCG negative. Ultrasound in 16 cases showed mixed echo light mass with rich blood flow in the uterine cavity, and magnetic resonance examination in 14 cases also showed abnormal signals in the uterine cavity or uterine wall. Mass staining was seen in 6 cases by DSA, vein development in advance, contrast medium overflow was seen in 2 cases, and the conclusion of CTA was consistent with DSA in 5 cases. Uterine artery embolization was performed in 5 cases, including 2 cases of massive bleeding, emergency bilateral uterine artery embolization and 3 cases of preventive embolization. Hysteroscopy was performed in 4 cases after embolization, and balloon compression was performed in 1 case because there was no obvious tissue in the uterine cavity. Hysteroscopy were performed in 10 cases without UAE. Mifepristone combined with misoprostol was used in 1 case. Among the 15 patients treated by surgery, 14 cases showed degenerative trophoblasts or villi. During the follow-up, one patient after uterine artery embolization complained of decreased menstruation, and ultrasound considered the possibility of intrauterine adhesion.Conclusion:After termination of pregnancy, imaging examination should be strengthened to guard against the occurrence of UAVM. Once diagnosed, medical intervention should be started as soon as possible to reduce bleeding. There is no standardized treatment for UAVM related to pregnancy. Comprehensive consideration should be given to the clinical manifestations, bleeding situation, lesion location and fertility requirements of the patients.