摘要
目的观察血管造影技术引导下超选择性子宫动脉栓塞(UAE)对子宫肌瘤患者卵巢功能、生育功能及远期复发的影响。方法选取2017年-2020年我院子宫肌瘤患者398例,随机数字表法分为两组,每组4.9例,对照组采取腹腔镜下子宫肌瘤剔除术治疗,观察组采取血管造影技术引导下超选择性UAE术治疗。观察两组临床疗效、手术相关指标、生育功能及复发情况,记录手术前后卵巢功能[黄体生成激素(LH)、雌二醇(E2)、卵泡生成激素(FSH)]、免疫炎性反应指标[白介素-6(IL-6)、白介素-10(IL-10)、肿瘤坏死因子-α(TNF-α]、肿瘤相关指标[基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)、组织金属蛋白酶抑制剂-2(TIM P-2)、组织金属蛋白酶抑制剂-9(TIMP-9)]水平。结果观察组总有效率97.96%与对照组91.84%无显著差异(P>0.05);观察组手术时间长于对照组,术中出血量少于对照组,术后下床活动及住院时间均短于对照组(P<0.05);术后1d,两组血清IL-6、TNF-α水平均较术前升高,且观察组低于对照组,两组血清IL-10水平较术前降低,,且观察组高于对照组(P<0.05);术后3个月,两组血清IL-6、IL-10、TNF-α水平均较术前改善(P<0.05);术后3个月,两组血清E2、FSH、LH水平均较术前降低,且观察组低于对照组(P<0.05);两组术后3个月血清MMP-2、MMP-9水平均较术前降低,TIMP-2、TIMP-9水平较术前升高(P<0.0.5);随访3年,观察组妊娠率54.76%、复发率4.76%与对照组50.00%、2.27%无显著差异(P>0.05)。结论血管造影技术引导下超选择性UAE术治疗子宫肌瘤患者疗效显著,能优化手术情况,促进术后恢复,减轻炎症免疫损伤,加快卵巢功能、生育功能改善,且远期复发率低。
Objective To observe the effect of superselective uterine artery embolization(UAE)guided by angiography on ovarian function,fertility function and long-term recurrence in patients with uterine fibroids.Methods 98 patients with uterine fibroids in our hospital from 2017 to 2020 were selected and divided into two groups with 49 cases in each group by random number table method.The control group was treated with laparoscopic myomectomy,and the observation group was treated with super-selective UAE guided by angiography technology.The clinical efficacy,surgery-related indexes,fertility function and recurrence of the two groups were observed.Ovarian function[luteinizing hormone(LH),estradiol(E2),follicle-forming hormone(FSH)],immunoinflammatory response indexes[interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)],tumor related indexes[matrix metalloproteinase-2(MMP-2),and radicals]were recorded before and after surgery Plasma metalloproteinase-9(MMP-9),tissue metalloproteinase-2(TIMP-2),tissue metalloproteinase-9(TIMP-9)]levels.ResultsThe total effective rate of the observation group was 97.96%and the control group was 91.84%(P>0.05).The operation time of the observation group was longer than that of the control group,the amount of blood loss during the operation was less than that of the control group,and the postoperative getting out of bed and staying in hospital were shorter than that of the control group(P<0.05).One day after surgery,the levels of serum IL-6 and TNF-αin 2 groups were higher than before surgery,and the observation group was lower than the control group,and the serum IL-10 level in 2 groups was lower than before surgery,and the observation group was higher than the control group(P<0.05).At 3 months after operation,serum levels of IL-6,IL-10 and TNF-αin 2 groups were improved compared with those before operation(P<0.05).At 3 months after operation,the levels of serum E2,FSH and LH in 2 groups were lower than those before operation,and the observation group was lower than the control group(P<0.05).Serum levels of MMP-2 and MMP-9 were decreased in both groups 3 months after operation,while the levels of TIMP-2 and TIMP-9 were increased compared with those before operation(P<0.05).After 3 years of follow-up,the pregnancy rate of 54.76%and recurrence rate of 4.76%in observation group were not significantly different from 50.00%and 2.27%in control group(P>0.05).ConclusionSuper-selective UAE guided by angiography is effective in the treatment of patients with uterine fibroids,which can optimize the operation,promote postoperative recovery,reduce inflammatory immune damage,accelerate the improvement of ovarian function and fertility function,and have a low long-term recurrence rate.
作者
高辉玲
金钊
郑国
许小雪
GAO Hui-ling;JIN Zhao;ZHENG Guo;XU Xiao-xue(Department of Interventional Radiology,Hebei Maternity Hospital,Shijiazhuang 050000,Hebei Province,China;Department of Radiology,Quyang County People's Hospital,Baoding 073100,Hebei Province,China)
出处
《中国CT和MRI杂志》
2024年第3期141-144,共4页
Chinese Journal of CT and MRI
基金
石家庄市科学技术研究与发展计划项目(223460663)。
关键词
子宫肌瘤
血管造影技术
超选择性子宫动脉栓塞
卵巢功能
生育功能
远期复发
Uterine Fibroids
Angiography
Superselective Uterine Artery Embolization
Ovarian Function
Reproductive Function
Late Recurrence
