子宫肌瘤的子宫动脉栓塞和子宫切除术的比较研究

The comparative study of uterine fibroids treatment by uterine artery Embolization with hysterectomy

目的将子宫动脉栓塞治疗症状性子宫肌瘤与子宫切除术进行比较 ,评价子宫动脉栓塞的有效性和安全性。方法 5 1例症状性子宫肌瘤患者被随机分到UAE组和子宫切除组进行前瞻性临床试验 ,评价两种方法有效性和安全性的指标分别是阴道出血停止、住院天数、术后恢复日常活动的天数和产生的并发症。结果UAE组内根据阴道出血停止的有效率为 96 9% (31/ 32例 ) ,与子宫切除组相似 (P >0 0 5 )。中位住院天数是 4 6 2天 ,术后恢复日常活动的天数是 9 80天 ,均比子宫切除组短 (P <0 0 0 1)。术中、术后并发症以轻微和中等并发症多见 ,而子宫切除组以中等和严重并发症多见。结论UAE作为一种替代子宫切除术治疗子宫肌瘤的方法 ,是安全有效的 ,其住院时间短 ,恢复快 ,严重并发症少。

Objective To evaluate the effectiveness and safety of uterine artery embolization (UAE) in the management of symptom in patients with uterine fibroids and to compare UAE with hysterectomy.Methods A prospective clinical trial was performed with 51 patients who were randomly assigned to one of two groups:UAE group and Hysterectomy group.The primary variables that were considered for evaluation of the effectiveness and safety of two procedures were respectively bleeding cessation,total length of hospital stay,the days of recovery after the operation,and the resulting complications.Results The clinical success rate for the patients who underwent UAE was 96.9% (31 of 32 patients).The mean hospital stay for UAE group was 4.62 days,and the days of recovery after the operation were 9.8,they were shorter than that for Hysterectomy group(P<0.001).During、after the UAE operation,the resulting complications of patients were often light and middle,in contrast to underwent the hysterectomy operation,they were middle and serious.Conclusion Compared with hysterectomy,UAE as a treatment alternative to uterine fibroids is safe and effective,necessitates a shorter hospital stay and recovery time,and results in fewer major complications.