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目的总结子宫动脉栓塞治疗子宫肌瘤的并发症及防治经验。方法自2008年以来,使用子宫动脉栓塞治疗子宫肌瘤100例。选择自愿接受介入治疗的症状性子宫肌瘤及无症状子宫肌瘤,直径>4 cm患者38例,术前检查排除带蒂浆膜下子宫肌瘤,采用Seldinger技术经皮股动脉穿刺插管行子宫动脉栓塞治疗,栓塞剂为海藻酸钠微球(KMG)、新鲜明胶海绵颗粒。结果 45例患者出现腰骶部疼痛症状,及时消炎镇痛,该症状在一周左右得到缓解,三周后症状消失;20例患者治疗后出现低热症状(37℃～37.5℃);12例患者便秘术后24 h患者下床活动后,常规嘱患者服用缓泻剂,一般术后2～3 d,大便通畅;23例黏膜下子宫肌瘤患者实施UAE治疗后15、30 d时坏死的肌瘤细胞由宫颈外口脱出,及时摘除病理组织,患者术后状态恢复良好,没有产生严重的并发症。宫腔感染采用子宫全切术后恢复正常。结论治疗后可使子宫肌瘤和子宫的体积明显缩小,对患者的不适症状能够显著改善。对于术后并发症要及时有效的纠正,有利于提高治疗效果。
Objective To summarize the complications and prevention and cure of uterine fibroids treated by uterine artery embolization. Methods Since 2008, uterine fibroids have been treated with uterine artery embolization in 100 cases. Select the voluntary interventional treatment of symptomatic uterine fibroids and asymptomatic uterine fibroids, 38 patients> 4 cm in diameter, preoperative examination to exclude subserosal myomectomy, the use of Seldinger percutaneous femoral artery puncture intubation Uterine artery embolization, embolic agents for sodium alginate microspheres (KMG), fresh gelatin sponge particles. Results 45 patients had symptoms of lumbosacral pain and timely anti-inflammatory and analgesic. The symptoms were relieved in about one week and disappeared after three weeks. Twenty patients had hypothermia (37 ℃ -37.5 ℃) after treatment; 12 patients had constipation 24 h after surgery patients get out of bed, regular hospice patients taking laxatives, usually 2 to 3 d after surgery, stool smooth; 23 patients with submucosal uterine fibroids after UAE treatment of necrotic fibroids cells 15, 30 d From the cervix outside the mouth, timely removal of pathological tissue, the patient recovered well after surgery, did not produce serious complications. Uterine infection after hysterectomy returned to normal. Conclusion After treatment, uterine fibroids and uterine volume can be significantly reduced, the patient’s symptoms can be significantly improved. For postoperative complications to be timely and effective correction, help to improve the therapeutic effect.