子宮動脈栓塞術治療子宮肌瘤及其照護

Uterine Artery Embolization for Uterine Fibroids

子宮肌瘤是婦科中常見的良性腫瘤，在未停經婦女之發生率約20％至77％，子宮肌瘤會有經血量過多、經痛、腹脹、性交痛等症狀，這些症狀皆影響到婦女的健康及生活品質。對於想保有子宮或欲再生育者，會選擇藥物荷爾蒙(gonadotropin-releasing hormone, GnRH)、肌瘤切除術(myomectomy)等來治療；而對於拒絕手術或藥物治療者，子宮動脈栓塞術(uterine artery embolization, UAE)則增加病患治療肌瘤之選擇性。UAE是一種新型的微創(new minimally invasive)手術，自1995年起即用來治療子宮肌瘤，依據累積的經驗顯示它可有效安全的治療子宮肌瘤。病患在術後可能有栓塞後症候群(postembolization syndrome, PES)出現，其症狀包括有下腹部疼痛、陰道出血、背痛、發燒等等。因此，護理人員應了解UAE之治療過程及術後合併症，使能提供個別性的照護及提昇專業照護品質。

Uterine fibroid is a common gynecologic benign tumor. The incidence is as high as 20-77% in premenopausal women. Fibroid-related symptoms include menorrhagia, dysmenorrhea, abdominal fullness, and dyspareunia, etc. All of these symptoms may influence women’s health and quality of life. Myomectomy and hormone therapy (gonadotropin-releasing hormone, GnRH) can be used for those who wish to preserve their uterus or maintain fertility potential. However, uterine artery embolization (UAE) may be an alternative for those who refuse to have surgery or medical therapy. UAE is accepted to be a new minimally invasive procedure. The cumulative experience has disclosed that UAE is effective and safe clinically in the treatment of uterine fibroids. Patients may suffer post-embolization syndrome which includes lower abdominal pain, vaginal bleeding, backache, fever, etc. Therefore, nurses should understand the treatment course and complications of UAE to provide individualized patient care and promote the quality of care.