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目的 了解子宫动脉栓塞术 (UAE)治疗子宫腺肌病前后血流动力学的变化。方法 对3 0例用明胶海绵为栓塞剂行UAE治疗的子宫腺肌病患者 ,于UAE前 1周内和UAE后 7、3 0、90d行经腹部彩色多普勒超声检查 ,测量双侧子宫动脉平均流速 (Vm)、阻力指数 (RI)、搏动指数 (PI) ,并用能量图 (CDE)观察正常子宫肌层和病灶内的血流情况。结果 ( 1)与UAE前相比 ,UAE后Vm、RI、PI均明显减少 (P <0 0 1) ,以UAE后 7d下降最为明显 ,其中Vm下降了 63 % [UAE前为 ( 41± 11)cm/s,UAE后 7d为 ( 15± 9)cm/s],差异有极显著性 (P <0 0 1) ;UAE后 3 0、90d虽逐步上升 ,其中Vm较UAE前仍分别下降 41% [( 2 4± 9)cm/s]和 41% [( 2 4± 10 )cm/s],与UAE后 7d比较 ,差异有显著性 (P<0 0 5 )。( 2 )UAE后 7d ,正常子宫肌层血流稀少 ,病灶内血流稀少或无血流 ;UAE后 3 0、90d ,正常子宫肌层的血流逐渐增多 ,病灶内血流仍稀少或无血流。结论 用明胶海绵行UAE治疗子宫腺肌病后7～ 3 0d ,子宫肌层的血液供应逐渐恢复 ,病灶的血液供应绝大部分不能恢复
Objective To investigate the changes of hemodynamics before and after uterine arterial embolization (UAE) for treatment of adenomyosis. Methods Thirty patients with adenomyosis treated by UAE with gelatin sponge as embolic agents were examined by abdominal color Doppler ultrasonography within 1 week before UAE and 7, 30, 90 days after UAE. The bilateral uterine arteries (Vm), resistance index (RI) and pulsatility index (PI), and the blood flow in normal myometrium and lesion was observed with energy chart (CDE). Results (1) Vm, RI and PI were significantly decreased (P <0.01) after UAE compared with those before UAE, and decreased most significantly at 7 days after UAE, with a Vm decrease of 63% [before UAE (41 ± 11 ) cm / s and (15 ± 9) cm / s at 7 days after UAE, the difference was highly significant (P <0.01). After UAE, the levels of Vm increased gradually at 30 and 90 days, 41% [(24 ± 9) cm / s] and 41% [(24 ± 10) cm / s], respectively, compared with the 7th day after UAE (P <0.05). (2) At 7 days after UAE, the myometrium was sparse and the blood flow was scarce or no blood flow in the myometrium. After 30 days and 90 days of UAE, the blood flow of normal myometrium gradually increased, and the blood flow in the lesion was still scarce or no Blood flow. Conclusion After gelatin sponge treatment of adenomyosis with UAE 7 ~ 30d, the myometrium blood supply gradually restored, the vast majority of the lesion blood supply can not be restored