| Background: Uterine fibroid is a popular benign tumor of female reproduction system. Routine therapy for uterine fibroids include hysterectomy, uterine hypo-resection, hormone medication therapy and so on. Uterine artery embolization(UAE) was first reported by Ravina for the treatment of symptomatic uterine fibroids in 1995. Due to the advantages of simplicity, minimal invasion, safety and effectiveness, keeping the uterus and short hospital stay, it has been increasingly used all over the world.Objective: To investigate the application of Dextran microspheres and Embosphere microspheres in the uterine artery embolization (UAE) for uterine leiomyoma respectively, we had reviewed the patient's menses improvement, the changes of uterine and leiomyoma size, complications and side effects at 6 and 12 months after embolization, and compared the short-term clinical efficacy and safety resulting from these two microspheres.Methods: Thirty-eight patients, whose mean age was (42±4.95)years old, with uterine leiomyoma were treated by UAE from April 2008 to July 2010. They were randomly divided into two equal groups, each group has 19 patients. Group A were treated by Dextran microspheres(Sephadex G-50,100-300μm) as embolic agents and group B were treated by Embosphere microspheres(Biosphere Medical,300-500μm). The uterine artery embolization was performed under local anesthesia with Seldinger's percutaneous technique using 4F Cobra or 5F RUC catheter. During follow-up intervals, the patients menses and symptoms improvement, the changes of uterine and leiomyoma size, complications and side effects were reviewed.Results: The technical success rate was 100% in two groups. In group A, the reductional rate of uterine volume was(49.2±4.3)%,(57±4.9)% at 6 months and 12 months post embolization respectively and reductional rate of uterine volume had statistical difference between pre and post-operation (P<0.05), but had no statistical difference between 6 months and 12 months post embolization (P>0.05). In group B, the reductional rate of uterine volume was(50.3±6.4)%,(58.3±7.3)% at 6 months and 12 months post embolization respectively and reductional rate of uterine volume have statistical difference between pre and post-operation (P<0.05), but had no statistical difference between 6 months and 12 months post embolization (P>0.05 ) The reductional rate of uterine volume at 6 months and 12 months post embolization had no statistical difference(P>0.05) between group A and group B. In group A,the reductional rate of leiomyoma volume was(53.9±7.3)%,(63.9±7.8)% at 6 months and 12 months post embolization respectively and the reductional rate of uterine leiomyoma volume had statistical difference between pre and post-operation(P<0.05), but had no statistical difference between 6 months and 12 months post embolization (P>0.05). In group B, the reductional rate of leiomyoma volume was(54.8±9.0)%,(65.5±12.3)% at 6 months and 12 months post embolization respectively and the reductional rate of leiomyoma volume had statistical difference between pre and post-operation (P<0.05),but had no statistical difference between 6 months and 12 months post embolization (P>0.05). The reductional rate of leiomyoma volume at 6 months and 12 months post embolization had no statistical difference(P>0.05) between group A and group B. The menses and symptoms of patients in two groups were also improved markly and had no statistical difference(P>0.05) between the two groups. No serious complications occurred in both groups.Conclusion: The short-term clinical efficacy and safety of Dextran microspheres and Embosphere microspheres have no statistical difference in UAE . The long-term clinical efficacy observation is warranted. However, Dextran microspheres are much cheaper, more easy to preparation than Embosphere microspheres. |
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