经导管子宫动脉栓塞治疗子宫肌瘤并发闭经的原因分析

陈晓明 杜娟 左约维 李勇 陆骊工 胡宝山 胡小平 罗鹏飞 洪淡华
【摘要】 目的 探讨经导管子宫动脉栓塞( TUAE) 治疗子宫肌瘤并发闭经的原因。方法 搜
集1999 年4 月至2004 年5 月, 接受TUAE 治疗的子宫肌瘤患者231 例, 年龄29 ～51 岁, 平均39. 5
岁。TUAE 均采用经导管双侧子宫动脉注射碘油-平阳霉素乳剂的方式, 其中碘油用量6 ～20 ml, 平阳
霉素用量8 ～16 mg, 231 例中186 例加用明胶海绵颗粒栓塞。结果 231 例中2 例分别于TUAE 后3
和4 个月发生闭经, 发生率0. 87% 。1 例考虑为卵巢功能受损引起的闭经, 表现为雌二醇( E2) 下降,
促卵泡成熟激素( FSH) 增高, 经过1 年的雌孕激素序贯治疗, 患者月经逐渐恢复正常; 另1 例经宫腔
镜证实为子宫内膜萎缩所致。结论 TUAE 后极少数人可发生闭经, 其原因与卵巢功能受损及子宫
内膜萎缩有关。
【关键词】 子宫肿瘤; 栓塞, 治疗性; 闭经; 手术后并发症
Ana lysis of amenor rhea after t ranscatheter uter ine ar ter y embolization for uter ine fibr oids CHEN
Xia o-ming, DU Juan, ZUO Yue-wei, LI Yong, LU Li-gong, HU Ba o-shan, HU Xia o-ping, LUO Peng-fei,
HONG Dan-hua. Depa rtment of Interventional Ra diology, Gua ngdong Provincial People′s Hospital,
Guangzhou 510080, China
【Abstra ct 】 Obj ective To investigate the causes of amenorrhea after transcatheter uterine artery
embolization( TUAE) for uterine fibroids. Methods Two hundreds thirty-one cases of uterine fibroids with
the range of age from 29 to 51 years ( mean, 39. 5 ys) underwent TUAE between April 1999 and May 2004.
TUAE was performed by injectingne cases of uterine fibroids with the range of age from 29 to 51 years (
mean, 39. 5 ys ) underwent TUAE between April 1999 and May 2004. TUAE was performed by injecting
lipiodol-pingyangmycin emulsion ( LPE) into bilateral uterine arteries, followed by administration of gelatin
sponge particles in 186 of 231 patients. LPE was prepared with pingyangmycin 8 ～16 mg and ultra fluid
lipiodol 6 ～20 ml. Results Amenorrhea occurred in 2 of 231 ( 0. 87% ) patients respectively at 3 and 4
months after TUAE. Premature ovarian failure was proved to be etiology of amenorrhea in one patient because
her serum estradiol ( E2 ) became decreased and serum follicle-stimulating hormone ( FSH) level increased.
This woman had normal menorrhea later after receiving estrogen-progestogen sepuential therapy for 12
months. Another patient′s amenorrhea was proved to be associated with endometrial atrophy after TUAE by
hysteroscope. Conclusion Amenorrhea caused by premature ovarian failure and endometrial atrophy may
occur in a tiny minority of women undergoing TUAE.
【Key words 】 Uterine neoplasms ; Embolization, therapeutic; Amenorrhea; Postoperative
complications

经导管子宫动脉栓塞治疗子宫肌瘤并发闭经的原因分析.rar