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山东大学学报(医学版)

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子宫动脉造影解剖及其血管内栓塞治疗的研究

高莉,李彩霞   

  1. 山东大学齐鲁医院影像中心, 山东 济南 250012
  • 收稿日期:2005-09-23 修回日期:1900-01-01 出版日期:2006-12-24 发布日期:2006-12-24
  • 通讯作者: 高莉

GAO Li,LI Cai-xia   

  • Received:2005-09-23 Revised:1900-01-01 Online:2006-12-24 Published:2006-12-24
  • Contact: GAO Li

摘要: 探讨子宫动脉造影解剖及其血管内栓塞治疗的临床疗效。方法:采用Seldinger技术,行双侧髂内-子宫动脉造影,了解子宫动脉解剖以及子宫肌瘤的血供状况,超选择插入子宫肌瘤供血动脉内并行栓塞治疗。结果:60例患者子宫动脉均由同侧髂内动脉发出,60%子宫动脉起源于髂内动脉前干,对侧斜位显示子宫动脉开口及行程为最佳投照体位。子宫肌瘤由双侧子宫动脉供血并均显示丰富,呈双侧优势型35例,占58.3%;双侧子宫动脉均参与供血,但一侧供血较对侧明显丰富,供血量超过子宫肌瘤瘤体的1/2,呈单侧优势型21例,占35%;仅有一侧子宫动脉参与供血,呈单侧供血型4例, 占6.7%。术后患者原有的症状消失。B超复查显示,术后3个月肌瘤平均缩小40%,6个月平均缩小55%,12个月平均缩小60%。结论:子宫动脉栓塞治疗子宫肌瘤安全有效;了解子宫动脉解剖及子宫肌瘤的血管构筑,可提高技术成功率

关键词: 栓塞, 治疗性 , 动脉, 平滑肌瘤, 子宫

Abstract: To investigate the uterine arteriography and the response of endovascular embolization for uterine fibroids. Methods: Bilateral internal iliac and uterine arteriography was performed on 60 patients and the angioarchitectures were observed in uterine fibroids with Seldinger technique. The feeding arteries of uterine fibroids were dealt with embolization. Results: The iliac arteries branched to uterine arteries in all 60 cases and 60% of the uterine arteries originated from the anterior trunk of iliac artery. Contralateral oblique view was the best position projected to show the opening and route of the uterine artery. The feeding arteries of uterine fibroids showed the bilateral dominant in 35 cases (58.3%), the unilateral dominant in 21 cases (35%) and the unilateral artery feeding in only 4 cases (6.7%). The symptoms of uterine fibrosis disappeared in all patients after vascular embolization. Followup with ultrasound found the fibroids decreased by 40% in size after 3 months of embolization, 55% after 6 months and 60% after 12 months. Conclusion: Embolization of the uterine artery for uterine fibroid is an effective method. Understanding the angioarchitecture and obstructing all the feeding arteries are of great importance for improving the success rate.

Key words: Uterus, Arteries, Leiomyoma, Embolization, therapeuti

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