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Objective:The objective of this thesis is to observe the changes of the endometrium after uterine arterial embolization (UAE), which focus in:1. continuously monitor endometrial thickness, morphology, endometrial and endometrial blood flow classifications, endometrial wave movement types and frequencies and pulsatility index (PI), resistance index (RI) of uterine and endometrial artery for 6 months after UAE; 2. Discuss the effects to endometrium using different embolic agents, time of surgery and other factors.Methods:Randomly draw 60 uterine fibroids which have UAE voluntarily and divide them in to group A1, A2, B1 and B2. According to the types of embolic agents used, further divide these 2 groups into group A1, A2, B1 and B2. Apply UAE to Al and A2 patients before ovulation; apply UAE to B1 and B2 patients 5 days before menses. Apply the mixture of Cephalosporin antibiotics, contrast medium and gelatin sponge particles as embolic agents to A1 and B1 patients, and mixture of Cephalosporin antibiotics, contrast medium and KMG/PVA as embolic agents to A2 and B2 patients.Examine and measure uterine volume, leiomyoma volume, endometrial thickness, morphology, endometrial and endometrial blood flow classifications, endometrial wave movement types and frequencies, PI, RI of uterine and endometrial artery of these four groups of patients using transvaginal color Doppler ultrasound by the same doctor 7 days before and 1,3, and 6 months after UAE.All the data involved in this research are processed by SPSS 13.0. Data measured are expressed by(x±s), measurement data are tested by t-test, the comparisons of measurement data between these four groups of patients are tested by paired t-test, enumeration data are tested by x2-test, the comparisons of enumeration data between these four groups of patients are tested by analysis of variance. Statistical differences are considered significant if P＜0.05.Results:The volume of the uterine and leiomyoma are reduced after UAE, the measurements of hemoglobin rise after UAE, durations of menses are shorter after UAE. The differences before and after UAE of all groups are significant (P＜0.01 or P＜0.05), while the differences amongst each group are not significant (P＞0.05).The endometrial and endometrial blood flow types are mainly typeⅢbefore UAE, and typeⅠand typeⅡafter UAE. PI and RI of uterine artery and endometrial artery drop after UAE. The differences before and after UAE of all groups are significant (P＜0.05), while the differences amongst each group are not significant (P＞0.05).The endometrium thicknesses of all groups are thinner and the numbers of blood flow on endometrium are reduced after UAE. Difference between group B1 and the other 3 groups is significant (P＜0.01 or P＜0.05), and the difference between B2 and A1, A2 is significant (P＜0.05), but the difference between A1 and A2 is not significant (P＞0.05).Conclusion:Uterine fibroids have good therapeutic effect after UAE, which shown in reduced leiomyoma volume and shorter duration of menses.Uterine receptivity drops 6 months after UAE. Uterine receptivity drops significantly when performing UAE in the later period of endometrium exudation using the mixture of Cephalosporin antibiotics, contrast medium and gelatin sponge particles as embolic agents.
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