Clinical Application Of Uterine Artery Embolization In The Treatment Of Adenomyosis

Objective:Uterine artery embolization for adenomyosis is more accepted clinical methods of conservative treatment, the study found that different uterine artery and uterine artery blood flow after treatment with rich clinical case of three typical symptoms: dysmenorrhea, menstrual flow uterine volume increased mitigation time is closely related. Respectively, after treatment at different time, different clinical cases of uterine artery and uterine artery blood flow in rich contrast to the situation and hope not only in the treatment and post-treatment on the prognosis of patients evaluated. Most hope to patients before treatment of uterine artery blood flow conditions and the degree of predictive, find out the personalized treatment programs for different patients to take a different treatment for different time after treatment has some therapeutic effect predicted. Uterine artery embolization for the treatment of adenomyosis Cheung actually gets to do a more objective evaluation.Methods:Uterine artery embolization treatment of126cases of adenomyosis, shows the different uterine artery and uterine artery blood flow rich case DSA angiography. Patients after0-3months,3-6months, and12months remission of clinical symptoms typical three Interrupted. For relief of dysmenorrhea pain using traditional grading method for the treatment of pain after a grade lower effective; menstrual flow improvements to their own comparison, than before treatment to reduce the original period of1/4as effective; changing the use of volume of uterine size changes as an indicator.This study used SPSS19.0software for statistical analysis, data not normally distributed, non-parametric test to compare each group to alleviate the symptoms of the number and volume change is statistically meaningful (P<0.05).Results:1. the uterine artery embolization in treating adenomyosis in126cases. To alleviate dysmenorrhea:0-6months for rapid remission of the most obvious treatment effect, to12months dysmenorrhea relief reached number93.65%, peak, up to5years when there is recurrence half of patients with dysmenorrhea. Menstrual quantity is improved:the treatment effect of0-12months are all obvious, anemia patients within3months of treatment effect of100%.1years later, no maintenance period and recurrence,5years after treatment still has effect. Uterine volume1years significantly reduced, and after1years of uterine volume tends to be stable, the overall trend of changes in1-5years after treatment is steady increase.2. Comparison of the uterine artery of four different types of patients with(unilateral uterine artery for blood type-A type; side of the main uterine artery type-B type; bilateral uterine artery Balanced-C-type; ovarian artery for blood-improving the D-type) clinical symptoms.2.1To relieve dysmenorrhea:0-3months when, B, C-type significantly ease dysmenorrhea; patients with three types of relief are similar in3-6months, there was no significant difference (P>0.05); total in a year There was no significant difference (P>0.05) effect of.2.2For the improvement of menstrual flow:In0-3months, the improvement in the amount of C-menstrual most obvious,(P<0.05); no significant difference (P in3-6months time Ⅲ>0.05);1There was no significant difference (P>0.05) in the year the total effect.2.3Comparison of changes in uterine size:0-3months, B, C-type uterine size change is most evident;3-6months when the A, B-type uterus shrink significantly; three types of change in6-12months no difference (P>0.05); total effect one year there are different (P<0.05) between the groups. B-type general display the first6months of the uterus quickly narrow, A-type in the3months after uterine quickly narrow, C yielded steady state continue to shrink.3. Be classified (very rich blood supply blood type according to the degree of the uterus-Class Ⅰ; rich blood type-Ⅱ class; General blood type-Ⅲ class; non-rich blood type-Ⅳ class.3.1To relieve dysmenorrhea:0-3months class Ⅲ relieve dysmenorrhea obvious; no significant difference (P>0.05) in3-6months time categories; no significant difference in the overall effect of a year in (P>0.05).3.2For menstrual flow improvements:a larger change in menstrual flow difference, I, Class II menstrual flow improvement is most evident; improvement in3-6months class II menstrual flow significantly; in effect for one year in total between three types of there are also differences (P<0.05). Overall, the effect of reducing class II most significant menstrual flow. 3.3Comparison of changes in uterine size:0-6months in the presence of various types of difference between changing the size of the uterus class I most obvious; But in6-12months class III uterus shrink significantly; categories overall efficacy in a year no significant differences (P>0.05). The overall display class I changed the earliest cases of uterine size, was continued to shrink rapidly in the0-6months, while Class III patients developed progressive narrowing of the uterus significantly in six months time. Class II patients continued to shrink the uterus steady state.4. Of the126cases, except cases of ovarian artery for blood, and the rest are for uterine artery blood type, according to DSA angiography ovarian branch of the uterine artery, ovarian vascular network, and even appeared six cases of ovarian artery divided into two groups to compare their case of secondary amenorrhea occurs through two-sample Wilcoxon test showed DSA angiography ovarian branch of the uterine artery, ovarian vascular network, even time with secondary amenorrhea occurs ovarian artery correlated with ovarian amenorrhea support group longer.Conclusions:Uterine artery embolization with less trauma, less pain, fewer complications, less recurrence, treatment can be repeated and so on. In particular, retains the uterus and reproductive function, which can be accepted by the majority of patients. Practice has proved that:the method of treatment of adenomyosis uterine artery embolization for symptomatic adenomyosis typically have significant therapeutic effect, and will not cause long-term ischemia pelvic and uterine blood disorder affecting the function of the ovary and uterus, by DSA contrast analysis of cases of uterine artery blood flow and blood rich uterine artery can be different situations during and after treatment in the treatment of the patient’s symptoms and prognosis evaluation of time to find a personalized treatment plan for uterine artery embolization to treat uterine glands Andrew myopathy actually gets to do a more objective evaluation.