摘要
目的 探讨子宫肌瘤治疗中不同子宫动脉介入栓塞方案的临床疗效及对子宫血供、卵巢功能的影响.方法 回顾性选取2018年2月至2023年2月唐山市妇幼保健院收治的子宫肌瘤患者100例,依据子宫动脉介入栓塞方案不同分为三丙烯微球栓塞组和平阳霉素碘化油乳剂组,每组各50例.比较两组患者术前、术后6个月的子宫血供(子宫肌瘤内部、周边的最粗动脉血管径、收缩期峰值流速、平均流速、阻力指数)、卵巢功能[卵泡刺激素(FSH)、雌二醇、黄体生成素(LH)、孕酮]、子宫体积、肌瘤体积、平均月经期、平均月经量,并比较两组患者的临床疗效、术后综合征发生情况及复发情况.结果 术后6个月,两组患者子宫肌瘤内部、周边的最粗动脉血管径、收缩期峰值流速、平均流速均低于术前,阻力指数均高于术前,差异均有统计学意义(P＜0.05);两组患者术后6个月子宫肌瘤内部、周边的最粗动脉血管径、收缩期峰值流速、平均流速、阻力指数组间比较,差异均无统计学意义(P＞0.05).两组患者术后6个月的FSH、雌二醇、LH、孕酮水平与术前比较,差异均无统计学意义(P＞0.05);且两组患者术后6个月的FSH、雌二醇、LH、孕酮水平组间比较,差异均无统计学意义(P＞0.05).术后6个月,两组患者的平均月经期均短于术前,平均月经量均少于术前,差异均有统计学意义(P＜0.05);两组患者术后6个月的平均月经期、平均月经量组间比较,差异均无统计学意义(P＞0.05).三丙烯微球栓塞组患者的治疗总有效率(92.00％)与平阳霉素碘化油乳剂组患者(90.00％)相比,差异无统计学意义(P＞0.05).三丙烯微球栓塞组患者的术后综合征发生率为34.00％,明显低于平阳霉素碘化油乳剂组(64.00％),差异有统计学意义(P＜0.05).三丙烯微球栓塞组患者的复发率为0,明显低于平阳霉素碘化油乳剂组(12.00％),差异有统计学意义(P＜0.05).结论 子宫肌瘤治疗中,三丙烯微球栓塞和平阳霉素碘化油乳剂栓塞方案的疗效及对子宫血供、卵巢功能的影响相当,但采用三丙烯微球栓塞治疗的患者术后综合征发生率和复发率更低.
Abstract
Objective To investigate the efficacy of different uterine artery embolization schemes in the treatment of uterine fibroids and the influence on uterine blood supply and ovarian function.Methods A total of 100 patients with uterine fibroids admitted to Tangshan Maternal and Child Health Hospital from February 2018 to February 2023 were retrospectively selected and divided into the tripropene microspheres group and the pingyangmycin iodized oil emulsion group according to the uterine artery interventional embolization scheme,with 50 cases each.Uterine blood supply(diameter of the thickest arteries inside and around uterine fibroids,peak systolic velocity,average velocity,resistance index),ovar-ian function[follicle stimulating hormone(FSH),estradiol,luteinizing hormone(LH),progesterone],uterine volume,fibroid volume,average menstrual period,average menstrual volume before operation and at 6 months after operation of the two groups were analyzed,the clinical efficacy,postoperative syndrome occurrence and recurrence of the two groups were analyzed.Results At 6 months after operation,the diameter of the thic-kest arterial blood inside and around the uterine fibroids,the peak systolic velocity and the average velocity of the two groups were lower than those before operation,and the resistance index was higher than that before operation,the differences were statistically significant(P＜0.05).There were no statistically significant differences in the diameter of the thickest arterial blood,peak systolic velocity,average velocity and resistance index between the two groups at 6 months after operation(P＞0.05).There were no statistically significant differences in the levels of FSH,estradiol,LH and progesterone between the two groups at 6 months after operation and before operation(P＞0.05),and there was no statistically signifi-cant difference in the levels of FSH,estradiol,LH and progesterone between the two groups at 6 months after operation(P＞0.05).At 6 months after operation,the average menstrual period of the two groups was shorter than that before operation,and the average menstrual volume was less than that before operation,the differences were statistically significant(P＜0.05).There was no statistically significant difference in the average menstrual period and average menstrual volume between the two groups at 6 months after operation(P＞0.05).There was no statistically signifi-cant difference in the total effective rate between the tripropylene microsphere embolization group(92.00％)and the pingyangmycin lipiodol emul-sion group(90.00％)(P＞0.05).The incidence of postoperative syndrome in tripropene microspheres group was 34.00％,which was lower than that in pingyangmycin iodized oil emulsion group(64.00％),the difference was statistically significant(P＜0.05).The recurrence rate of tripropene microspheres group was 0,which was lower than that of pingyangmycin iodized oil emulsion group(12.00％),the difference was statis-tically significant(P＜0.05).Conclusion In the treatment of uterine fibroids,different uterine artery interventional embolization schemes have similar effects on uterine blood supply and ovarian function,but tripropene microspheres can reduce the incidence of postoperative syndrome and recurrence rate more than pingyangmycin iodized oil emulsion.
维普
万方数据