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Short-Term Results of Transcatheter Uterine Artery Embolization Using Lipiodol and Gelfoam Cubes for Symptomatic Uterine Leiomyoma
以油性碘Lipiodol與泡棉Gelfoam爲栓塞劑經由子宮動脈治療症狀性良性子宮肌瘤的短期結果
摘要
評估利用油性碘Lipiodol與泡棉Gelfoam為栓塞劑經子宮動脈治療症狀性良性子宮肌瘤的效果與安全性。 共有50位婦女接受以油性碘Lipiodol與泡棉Gelfoam為栓塞劑的子宮肌瘤栓塞手術。術前、術後四個月及術後一年的追蹤均以超音波測量婦女子宮與子宮肌瘤的體積並比較之。同時以問卷詢問因子宮肌瘤所引起的症狀改善的程度。 經血過多有明顯改善與改善者，在追蹤四個月與一年後分別是92.5%(37/40)與95%(20/21)。腫瘤壓迫所導致的症狀有明顯改善與改善者，在追蹤四個月與一年後分別是89%(24/27)與93%(13/14)。子宮體積在四個月與一年後分別平均減少了35%與43%。主要子宮肌瘤體積在四個月與一年後分別平均減少了51%與67%。子宮肌瘤栓塞術後所引起的腹腔疼痛方面，可藉由口服止痛藥的方式而獲得有效的控制。在併發症方面，有一位病人術後因為膀胱潰瘍引發的敗血症而再次入院。 證明利用油性碘Lipiodol與泡棉Gelfoam為栓塞劑的子宮肌瘤栓塞手術不僅可以使病人經歷較少的術後疼痛與術後併發症，同時也能獲得很好的滿意度。
並列摘要
To evaluate the effectiveness and safety of transcatheter uterine artery embolization (UAE) using lipiodol-gelfoam cube mixture for the treatment of symptomatic uterine leiomyomas. Fifty women with symptomatic uterine leiomyomas underwent transcatheter bilateral UAE using lipiodol and gelfoam cubes. Ultrasonography was used to assess the size of uterus and the dominant fibroids before, at 4 month and 1 year after UAE. A questionnaire was obtained to assess patients’ clinical outcome. Menorrhagia improved significantly or mildly in 37 (92.5%) of 40 patients at 4 months after embolization and 20 (95%) of 21 patients at 1 year after embolization. Bulk-related symptoms improved significantly or mildly in 24 (89%) of 27 patients at 4 months after embolization and in 13 (93%) of 14 patients at 1 year after embolization. The uterine and dominant fibroids volumes decreased by 35% and 51% at 4 months and 43% and 67% at 1 year respectively. Pain control was achieved easily by oral analgesics. One patient was readmitted because of sepsis and ulceration of the urinary bladder. UAE could be performed using a combination of lipiodol and gelfoam cubes with clinical results comparable to that obtained by traditional embolizers.
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