鲁景元,刘旸,徐文健.子宫动脉栓塞治疗症状性子宫腺肌病中长期疗效[J].中国介入影像与治疗学,2022,19(11):683-686
子宫动脉栓塞治疗症状性子宫腺肌病中长期疗效
Medium- and long-term efficacy of uterine artery embolization for symptomatic adenomyosis
投稿时间:2022-06-12  修订日期:2022-07-16
DOI:10.13929/j.issn.1672-8475.2022.11.003
中文关键词:  子宫腺肌病  子宫动脉  栓塞,治疗性  治疗结果
英文关键词:adenomyosis  uterine artery  embolization,therapeutic  treatment outcome
基金项目:江苏省妇幼保健协会科研项目(FYX202010)。
作者单位E-mail
鲁景元 南京医科大学附属妇产医院 南京市妇幼保健院放射介入科, 江苏 南京 210004  
刘旸 南京医科大学附属妇产医院 妇科, 江苏 南京 210004 lyangry@163.com 
徐文健 南京医科大学附属妇产医院 南京市妇幼保健院放射介入科, 江苏 南京 210004  
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中文摘要:
      目的 通过症状控制及生活质量改善评估子宫动脉栓塞(UAE)治疗症状性子宫腺肌病(AD)的中长期疗效。方法 回顾性分析56例接受UAE治疗的症状性AD患者的临床及5年随访资料,以痛经和月经量过多作为评价症状控制的主要指标,观察UAE前及后1~5年患者痛经视觉模拟量表(VAS)评分、月经量月经失血图(PBAC)评分、健康相关生活质量(HRQOL)评分、血清糖类抗原125(CA125)及子宫体积的变化;以Kaplan-Meier曲线法分析UAE治疗症状性AD及控制主要症状的有效率。结果 UAE后1~4年,痛经VAS评分、月经量PBAC评分、子宫体积、血清CA125及HRQOL评分均较术前有所改善(P均<0.05);UAE后5年,痛经VAS评分及HRQOL评分与术前差异均无统计学意义(P均>0.05)。UAE后1~5年,痛经有效控制率分别为92.86%、87.50%、80.36%、71.43%及55.36%,月经量过多有效控制率分别为98.21%、98.21%、94.64%、89.29%及76.79%。UAE对月经量过多的有效控制时间为(56.53±1.24)个月[95%CI(54.09,58.97)个月],对痛经的有效控制时间为(50.44±2.10)个月[95%CI(46.32,54.57)个月],差异有统计学意义(P=0.023)。结论 UAE治疗症状性AD的中长期疗效佳,且控制月经量过多优于痛经。
英文摘要:
      Objective To explore the medium- and long-term efficacy of uterine artery embolization (UAE) for symptomatic adenomyosis (AD) in terms of symptom control and improvement of life quality. Methods Clinical and 5-year follow-up data of 56 patients with symptomatic AD treated with UAE were retrospectively analyzed. Dysmenorrhea and hypermenorrhagia were selected as the main evaluation indexes of symptom control, and dysmenorrhea visual analogue scale (VAS), menstrual volume pictorial blood loss assessment chart score (PBAC), health-related quality of life (HRQOL) assessment, serum carbohydrate antigen 125 (CA125) and uterine volume were compared before and 1, 2, 3, 4, 5 years after treatment. Kaplan-Meier curve method was used to analyze the effective rate of main symptom control of UAE for treating symptomatic AD. Results There was no significant difference of dysmenorrhea VAS score and HRQOL score 5 years after UAE compared with those before treatment (both P>0.05), while dysmenorrhea VAS score, menstrual volume PBAC score, uterine volume, serum CA125 and HRQOL score at the other time points after treatment were improved compared with those before treatment (all P<0.05). One, 2, 3, 4 and 5 years after UAE, the effective control rate of dysmenorrhea in AD patients was 92.86%, 87.50%, 80.36%, 71.43% and 55.36%, respectively, and the effective control rate of hypermenorrhagia was 98.21%, 98.21%, 94.64%, 89.29% and 76.79%, respectively. The effective control time of menorrhagia after UAE was (56.53±1.24) months (95%CI [54.09, 58.97] months), while the effective control time of hypermenorrhagia was (50.44±2.10) months (95%CI [46.32, 54.57] months), and significant difference existed (P=0.023). Conclusion UAE had good medium- and long-term efficacy for treating symptomatic AD, and the control of menorrhagia symptoms was better than of dysmenorrhea symptoms.
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