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Bilateral Uterine Arterial Embolization for Treatment for Uterine Myoma

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Abstract

¸ñÀû: ÀڱñÙÁ¾ ȯÀÚµéÀ» ´ë»óÀ¸·Î ÇÏ¿© ¼ö¼úÀ» ÇÇÇÏ°í ½ÍÀº ȯÀÚ, °¡ÀÓ ¿©¼ºÀ¸·Î ÀÚ±ÃÀ» º¸Á¸ÇÏ°í ½ÍÀº ȯÀÚµéÀ» ´ë»óÀ¸ ·Î ¾çÃø Àڱõ¿¸Æ »öÀü¼úÀ» ½ÃÇàÇÏ¿© ¾çÃø Àڱõ¿¸Æ »öÀü¼úÀÌ ÀڱñÙÁ¾ Áõ»ó ¹× ±ÙÁ¾ÀÇ Å©±â¸¦ ¾ó¸¶³ª °¨¼Ò½Ãų ¼ö ÀÖ´ÂÁö¸¦ Æò°¡ÇϰíÀÚ ÇÏ¿´´Ù.

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°á°ú: ȯÀÚ±ºÀÇ Æò±Õ¿¬·ÉÀº 24¼¼ ¿¡¼­ 50¼¼·Î Æò±Õ 36.3¡¾7.9¼¼¿´°í, ±ÙÁ¾ÀÇ Æò±Õ Á÷°æÀº 4.8¡¾2.5 cmÀ̾ú°í, Æò±Õ ºÎÇÇ´Â 55.4 (46.3-67.4) cm3À̾ú´Ù. ±ÙÁ¾ÀÇ ÇüÅ´ °£Áú ¶Ç´Â ±ÙÃþ³» ±ÙÁ¾ÀÌ 9¿¹, Á¡¸·ÇϱÙÁ¾ÀÌ 6¿¹¿´°í, À帷ÇÏ ¶Ç´Â º¹¸·ÇÏ ±ÙÁ¾ ¹× À¯°æ¼º ±ÙÁ¾, ±¤°£¸· ±ÙÁ¾Àº ¾ø¾ú´Ù. Æò±ÕÀڱñÙÁ¾ ¿ëÀû°¨¼Ò´Â ½Ã¼ú ÈÄ 2ÁÖ ÈÄ, 6ÁÖ ÈÄ, 12ÁÖ ÈÄ¿¡ 58.6¡¾9.7%, 77.5¡¾12.3%, 86.8¡¾23.5%À¸·Î ÀڱñÙÁ¾ÀÇ Å©±â°¡ ÀÇ¹Ì ÀÖ°Ô °¨¼ÒÇÑ °ÍÀ» È®ÀÎÇÒ ¼ö ÀÖ¾ú´Ù. ÁúÃâÇ÷À̳ª ÇϺ¹ºÎ ÅëÁõÀÇ Áõ»óÀº ½Ã¼ú 12ÁÖ ÈÄ ¸¹ÀÌ È£ÀüµÈ °æ¿ì°¡ 60%, ¾à°£ È£ÀüµÈ °æ¿ì°¡ 40%¿´À¸¸ç, È£ÀüÀÌ ¾ø°Å³ª ¾ÇÈ­µÈ °æ¿ì´Â ¾ø¾ú´Ù. ´ëºÎºÐÀÇ ¿¬±¸ ´ë»óÀÚ¿¡ À־ Áõ»óÀÇ È£ÀüÀ» º¸¿´´Ù. Àڱõ¿¸Æ »öÀü¼ú ½ÃÇà ÈÄ ÀüÀڱà ÀýÁ¦¼úÀ̳ª, ÀڱñÙÁ¾ ÀýÁ¦¼ú µîÀÇ ¼ö¼úÀ» ½ÃÇà ¹ÞÀº °æ¿ì´Â ¾ø¾úÀ¸¸ç, ÀڱñÙÁ¾ Å©±âÀÇ Áõ°¡³ª, Áõ»óÀÇ ¾ÇÈ­¸¦ º¸ÀÎ °æ¿ìµµ ¾ø¾ú´Ù. ½Ã¼ú ÈÄ ÇÕº´ÁõÀ¸ ·Î´Â ½Ã¼ú ÈÄ º¹ºÎÅëÁõÀÌ ¸ðµç ȯÀÚ¿¡°Ô¼­ ¹ß»ýÇÏ¿´À¸³ª, °¨¿°, Àڱñ«»ç, ³­¼Ò±â´ÉÀúÇÏ, ÀçÃâÇ÷, Ç÷Á¾ µîÀÇ ÇÕº´ÁõÀº ¾ø¾ú´Ù.

°á·Ð: µû¶ó¼­, Àڱõ¿¸Æ »öÀü¼úÀ» ÀÌ¿ëÇÑ ÀڱñÙÁ¾ÀÇ Ä¡·á´Â ¼ö¼ú·Î ÀÎÇÑ ÃâÇ÷À̳ª °¨¿°, ¿ä°ü¼Õ»ó µîÀÇ ºÎÀÛ¿ëÀ» ÃÖ´ëÇÑ ÁÙÀÏ ¼ö ÀÖÀ¸¸ç, ´ú ħ½ÀÀûÀÎ Ä¡·á¹æ¹ýÀ¸·Î, ¹«¾ùº¸´Ùµµ Àڱ󻸷 ¼Õ»óÀÌ °ÅÀÇ ¾ø¾î °¡ÀÓ ¿©¼º¿¡¼­ »ý½Ä´É·ÂÀ» º¸Á¸ÇÒ ¼ö ÀÖ´Ù´Â ÀåÁ¡À» °¡Áø À¯¿ëÇÏ°í ¾ÈÀüÇÑ Ä¡·á¹æ¹ýÀÌ µÉ °ÍÀÌ´Ù.

Objective: The purpose of this study is to evaluate the effectiveness and safety of uterine artery embolization for the treatment of symptomatic leiomyomas in the patients who want to preserve uterus, want fertility or feel fear for operation.

Methods: From January 2003 to June 2005, among the patients with symptomatic uterine leiomyoma, fifteen women who wanted to preserve uterus or wanted fertility or had fear for operation were included in this retrospective study. Bilateral Uterine artery embolization (UAE) was performed. At the preprocedure and at 2, 6, and 12 weeks of postprocedure, transvaginal ultrasonography was performed for all patients. Clinical symptoms and follow-up information for each patient were evaluated.

Results: 15 leimyomas were treated with UAE. The initial mean volume of leiomyomas was 55.4 (46.3-67.4) cm3. The mean volume decrease was 58.6¡¾9.7%, 77.5¡¾12.3%, 86.8¡¾23.5% at 2, 6, 12 weeks. The outcome of clinical symptoms were as followed; ¡®much improved¡¯ 20% (3/15), ¡®somewhat improved¡¯ 60% (6/15), ¡®no improvement¡¯ 20% (3/15), ¡®somewhat worsen¡¯s 0% (0/15), and ¡®much worsen¡¯ was 0% (0/15). There was no case of hysterectomy or myomectomy after UAE. And also no case of increasement of volume nor worsening of clinical symptoms were found. Lower abdominal pain was the most common symptoms after UAE, but complications were not detected.

Conclusion: In this study, UAE to treat patients with uterine leiomyoma is proved to be effective not only in volume reduction, but also in symptom improvement. And it is a relatively less-invasive procedure which decreases the risk of side effects of operation. Above all things, it preserves fecundity in young women. Therefore, UAE is very effective and safe procedure in the treatment of symptomatic uterine leiomyoma.

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Àڱõ¿¸Æ »öÀü¼ú;ÀڱñÙÁ¾;Uterine artery embolization;Myoma uteri
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