子宫肌瘤动脉栓塞术改善子宫肌瘤患者预后与生活质量研究  

The Research of Outcome and Quality of Life after Uterine Artery Embolization

作　　者：张子东[1,2] 贾广志[1] 李建明[1] 王泽鑫[1] 关利君[1] 秦效军[1] 

机构地区：[1]内蒙古医科大学附属医院介入科,内蒙古呼和浩特010050 [2]内蒙古医科大学研究生学院,内蒙古呼和浩特010110

出　　处：《现代生物医学进展》2016年第28期5460-5463,共4页Progress in Modern Biomedicine

基　　金：内蒙古自治区自然科学基金项目(2009ms1218)

摘　　要：目的:评估子宫肌瘤动脉栓塞术(UAE)改善子宫肌瘤患者预后与生活质量。方法:选取在我院介入科住院治疗的400例子宫肌瘤患者,记录患者的再干预率和出血有关的临床症状。将症状持续、恶化、症状复发和再干预定义为治疗失败(TF)。使用Kaplan-Meier分析计算成功治疗的累积率。运用Cox回归分析计算临床或形态学预测因子。评估患者生活质量和更年期的变化情况。结果:400例患者中,328例患者(82.0%)完成随访。共有54例TF,对其中46例进行了再干预治疗。Kaplan-Meier分析表明,5年后TF累积率为23.3%。Cox回归分析表明,与45岁以上女性相比,40岁以下女性更易发生TF(OR=2.29,95%CI:1.02-5.19,P=0.048)。非TF患者治疗后疾病相关生活质量显著改善(P<0.001)。274例非TF患者中,有62(22.6%)例停经平均年龄为52岁。结论:UAE可以对83.5%的子宫肌瘤患者相关的症状予以长期控制,并使其生活正常化。与接近绝经期妇女相比,TF在年轻女性中的发生率更高。Objective： To evaluate the outcome and quality of life of patients after uterine artery embolization. Methods： A total of 400 patients with uterine fibroids treated in our hospital were included. The intervention rate and the clinical symptoms associated with bleeding all were calculated and recorded. Persistence, worsening or recurrence of symptoms and re-interventions were classified as treatment failure （TF）. Kaplan-Meier analysis was applied to determine the cumulative rate of TF. Cox regression was used to identify possible clinical or morphologic predictors of outcome. The quality of life and menopause changes were also evaluated. Results： Of the 400 patients, 328 （82%） patients were followed up. 54 patients had treatment failure, and 46 of them had re-intervention therapy. Kaplan-Meier analysis showed that the cumulative rate of TF after 5 years was 23.3%. Cox regression analysis showed that patients under 40 years of old were more likely to get TF （OR=2.29, 95% CI： 1.02-5.19, P=0.048） than those over 45 years of old. The quality of life of non-TF patients after treatment was significant improved. Among the 274 cases of non-TF patients, average age of 62 （22.6%） menopause patients was 52 years. Conclusions： UAE leads to long-term control of fibroid-related symptoms and normalization of quality of life in approximately 83.5% of patients. Younger women seem to have a higher risk of TF than older women closer to menopause.

关 键 词：子宫肌瘤动脉栓塞术 预后 生活质量 

分 类 号：R711.74[医药卫生—妇产科学]