CAJ | 학술논문

目的探讨超声引导下经阴道瘤体内注射氨喋噙(MTX)治疗子宫肌瘤的疗效.方法对165例子宫肌瘤患者行超声引导下经阴道瘤体内注射MTX治疗,剂量50～60 mg,每月1次,连续注射3个月,超声下观察肌瘤体积变化.其中9例患者在注药1个月后接受手术治疗,切除的肌瘤标本送病理检查.结果注药1个月后体积与治疗前相比无明显变化(P>0.05);3次注药6个月后肌瘤体积与治疗前相比明显缩小(P<0.01),注药1年后肌瘤体积与注药2年后的体积相比较差异无显著性意义(P>0.05).注药后的肌瘤标本光镜下可见其单位视野内的血管数明显减少,并有管腔变窄,肌瘤细胞有明显的水肿及变性;电镜下可见瘤细胞内内质网及线粒体有明显的水肿及变性,而正常子宫肌组织未见异常.结论超声引导下经阴道瘤体内注射MTX治疗子宫肌瘤,疗效明显,操作简单,副作用小.
목적 탐토초성인도하경음도류체내주사안첩금(MTX)치료자궁기류적료효.방법 대165례자궁기류환자행초성인도하경음도류체내주사MTX치료,제량50～60 mg,매월1차,련속주사3개월,초성하관찰기류체적변화.기중9례환자재주약1개월후접수수술치료,절제적기류표본송병리검사.결과 주약1개월후체적여치료전상비무명현변화(P>0.05);3차주약6개월후기류체적여치료전상비명현축소(P<0.01),주약1년후기류체적여주약2년후적체적상비교차이무현저성의의(P>0.05).주약후적기류표본광경하가견기단위시야내적혈관수명현감소,병유관강변착,기류세포유명현적수종급변성;전경하가견류세포내내질망급선립체유명현적수종급변성,이정상자궁기조직미견이상.결론 초성인도하경음도류체내주사MTX치료자궁기류,료효명현,조작간단,부작용소.
Objective To investigate the efficiency of the treatment of uterine leiomyoma by ultrasoundguided injection of methotrexate(MTX)into leiomyoma transvaginally.Methods One hundred and sixtyfie cases of uterine myomas were treated with the ultrasound-guided injection of MTX into leiomyoma transvaginally,50～60 mg of MTX was injected into leiomyoma once a month for 3 consecutive months.The changes of myoma size before and after the injection were observed with ultrasound.Nine of 165 cases underwent hysterectomy or myomectomy 1 month after the injection.The specimens were studied pathologically.Results The mean tumor size of 156 patients was not significantly different between one month after the first injection/and before the injection(P>0.05).Six months after the third injections, the tumor sizes were significantly decreased,compared with those before the treatment(P<0.01).Two years later the tumor size was not significantly different from that after one year(P>0.05).Under the light microscope,blood vessels in five removed tumor specimens showed sparse distribution,indicating that blood vessels decreased in number and became narrower.Apparent degeneration and edema were found in leiomyoma tissues.Under the electronic microscope,degeneration and edema were observed in mitochondria and endoplasmic retichlum.Degeneration or necrosis were not seen in myometrium.Conclusion The ultrasound-guided injection of MTX into leiomyoma transvaginally has satisfactory definite prostecdtive efficacy.It is easily operated and has little side effect.