陳曉明 杜娟 左約維 李勇 陸驪工 胡寶山 胡小平 羅鵬飛 洪淡華
【摘要】 目的 探討經導管子宮動脈栓塞( TUAE) 治療子宮肌瘤并發閉經的原因。方法 搜
集1999 年4 月至2004 年5 月, 接受TUAE 治療的子宮肌瘤患者231 例, 年齡29 ~51 歲, 平均39. 5
歲。TUAE 均采用經導管雙側子宮動脈注射碘油-平陽霉素乳劑的方式, 其中碘油用量6 ~20 ml, 平陽
霉素用量8 ~16 mg, 231 例中186 例加用明膠海綿顆粒栓塞。結果 231 例中2 例分別于TUAE 后3
和4 個月發生閉經, 發生率0. 87% 。1 例考慮為卵巢功能受損引起的閉經, 表現為雌二醇( E2) 下降,
促卵泡成熟激素( FSH) 增高, 經過1 年的雌孕激素序貫治療, 患者月經逐漸恢復正常; 另1 例經宮腔
鏡證實為子宮內膜萎縮所致。結論 TUAE 后極少數人可發生閉經, 其原因與卵巢功能受損及子宮
內膜萎縮有關。
【關鍵詞】 子宮腫瘤; 栓塞, 治療性; 閉經; 手術后并發癥
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
經導管子宮動脈栓塞治療子宮肌瘤并發閉經的原因分析.rar