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目的 探讨超声引导下经阴道瘤体内注射MTX治疗子宫肌瘤的效果。方法 对 31例子宫肌瘤患者采用超声引导下经阴道瘤体内注射MTX ,剂量 5 0～ 6 0mg ,每月 1次 ,连续注射 3个月 ,定期B超复查 ,观察肌瘤体积的变化。切除的肌瘤标本行光镜和电镜下组织学观察分析并与未注药的同期肌瘤标本相比。结果 注药 1个月后体积与治疗前相比无明显变化 (P >0 0 5 ) ;第 2、3次注药 1个月后肌瘤体积与治疗前相比明显缩小 (P <0 0 1) ,注药 6个月后肌瘤体积与注药 3个月后的体积相比较差异无显著性意义 (P >0 0 5 )。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。结论 超声引导下经阴道MTX瘤体内注药治疗子宫肌瘤疗效确切 ,效果满意
Objective To investigate the effect of ultrasound-guided transdermal injection of MTX on uterine fibroids. Methods Thirty-one patients with uterine fibroids were treated with ultrasound-guided transdermal injection of MTX in a dose of 50-600 mg once a month for 3 months. The changes of fibroids volume were observed by regular B-ultrasound. Histological resections of the myometrium under light and electron microscopy histological analysis and compared with the same period of non-injected fibroids specimens. Results There was no significant difference in volume between 1 and 2 months after injection (P> 0.05), and the volume of fibroids was significantly reduced at 1 and 3 months after the second and third administrations (P <0 0 1). There was no significant difference between the volume of myoma and the volume of myoma after 3 months of injection (P> 0.05). After injection of fibroids, the number of blood vessels in the field of vision of the myofascial tissue was significantly reduced under light microscopy, with narrowing of the lumen and obvious edema and degeneration of myoma cells. The endoplasmic reticulum and mitochondria Obvious edema and degeneration. Conclusion Ultrasound-guided transvaginal MTX tumor injection in the treatment of uterine fibroids exact effect with satisfactory results