CAJ | 학술논문

背景:子宫动脉栓塞术作为治疗子宫肌瘤的重要手段已广泛应用于临床,疗效令人满意,但对子宫动脉栓塞术的基础研究目前尚处于起步阶段,理论系统尚不完善.应用新型栓塞剂三丙烯微球行豚鼠子宫肌瘤模型进行子宫动脉栓塞操作的相关文献报道作者尚未查到.目的:实验设计了以三丙烯微球进行豚鼠子宫肌瘤模型子宫动脉栓塞的可行性验证.方法:30只成年雌性豚鼠随机分为两组;盆腔动脉铸型组10只,用于行盆腔血管铸型术,了解雌性豚鼠子宫动脉起源、行程、长度、直径及分支等解剖学特征;子宫肌瘤模型动脉栓塞组20只,应用雌孕激素联合法诱导子宫肌瘤模型建立,并行双侧子宫动脉微球栓塞的技术研究及病理分析.结果与结论:双侧子宫动脉主干由髂内动脉发出,主干和弓状支的血管直径分别为(O.350±0.022)mm及(0.160±0.012)mm.子宫肌瘤模型动脉栓塞组20只豚鼠成功行双侧子宫动脉栓塞术.术中40～120μm及100～300 μm三丙烯微球的用量分别为(0.040±0.005)mL和(0.017±o.002)mL.子宫肌瘤模型动脉栓塞组肌瘤成模率达75%.病理切片可见子宫动脉弓状支、浆膜下二级分支及部分三级分支动脉内均有栓塞微球存在.子宫肌层增厚,肌瘤结节处细胞呈栅栏状或编织状排列.栓塞后肌瘤缺血坏死明显,子宫肌层及内膜无缺血坏死病理改变.说明应用三丙烯微球行豚鼠子宫肌瘤模型动脉栓塞术具有可行性,栓塞效果良好.
배경:자궁동맥전새술작위치료자궁기류적중요수단이엄범응용우림상,료효령인만의,단대자궁동맥전새술적기출연구목전상처우기보계단,이론계통상불완선.응용신형전새제삼병희미구행돈서자궁기류모형진행자궁동맥전새조작적상관문헌보도작자상미사도.목적:실험설계료이삼병희미구진행돈서자궁기류모형자궁동맥전새적가행성험증.방법:30지성년자성돈서수궤분위량조;분강동맥주형조10지,용우행분강혈관주형술,료해자성돈서자궁동맥기원、행정、장도、직경급분지등해부학특정;자궁기류모형동맥전새조20지,응용자잉격소연합법유도자궁기류모형건립,병행쌍측자궁동맥미구전새적기술연구급병리분석.결과여결론:쌍측자궁동맥주간유가내동맥발출,주간화궁상지적혈관직경분별위(O.350±0.022)mm급(0.160±0.012)mm.자궁기류모형동맥전새조20지돈서성공행쌍측자궁동맥전새술.술중40～120μm급100～300 μm삼병희미구적용량분별위(0.040±0.005)mL화(0.017±o.002)mL.자궁기류모형동맥전새조기류성모솔체75%.병리절편가견자궁동맥궁상지、장막하이급분지급부분삼급분지동맥내균유전새미구존재.자궁기층증후,기류결절처세포정책란상혹편직상배렬.전새후기류결혈배사명현,자궁기층급내막무결혈배사병리개변.설명응용삼병희미구행돈서자궁기류모형동맥전새술구유가행성,전새효과량호.
BACKGROUND: The uterine arterial embolization which is a major method to treat hysteromyoma has bean widely used in clinic and achieved a satisfactory therapeutic efficacy. The study addressing the effect of trisacryl gelatin microspheres on uterine arterial embolization in a hysteromyoma guinea pig model has less bean reported yet. OBJECTIVE: To vedfy the feesibility of trisacryl gelatin microspheres to uterine arterial embolization in hysteromyoma guinea pig models. METHODS: A total of 30 adult female guinea pigs were randomly divided into two groups: pelvic cavity artery moulding group (n=10) was performed pelvic vascular casting mould to demonstrate the anatomical characteristics, such as source, running shape, length, diameter and branches; arterial embolization group (n=20) was induced hysteromyoma model using astrogen-progestogen replacement therapy and performed technical research and pathological analysis by bilateral uterine arterial embolization. RESULTS AND CONCLUSION: The trunks of uterine arteries were erupted from internal iliac arteries. The diameter of the trunks and its arcuate branches were (0.350±0.022) mm and (0.160±0.012) mm, respectively. The 20 guinea pigs of the arterial embolization group were succeeded in operating bilateral arterial embolization. The dosage of 40-120 pm and 100-300 μm trisacryl gelatin microspheras were (0.040t±0.005) mL and (0.017±0.002) mL respectively during the operation. The achievement ratio of establishing model was 75% in the arterial embolization group. On the pathological section, the microspheres could be found in the uterine arterial arcuate branches and second branches within the subsercsa and third branches. The myometrium Was thickening. The cells of the leiomyoma nodules arranged in palisade or weaving shapes. Ischemia and necrosis were evidently present in leiomyomas of guinea pigs after embolization, but the myometria and endometria had no pathological change of ischemia and necrosis. It is feasible to use trisacryl gelatin microspheres to operate uterine arterial embolization for hysteromyoma of guinea pigs and the embolization effects are satisfactory.