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

作　　者：鲁景元[1] 刘旸 徐文健[1] LU Jingyuan;LIU Yang;XU Wenjian(Department of Interventional Radiology,Women's Hospital of Nanjing Medical University,Nanjing Maternity and Child Health Care Hospital,Nanjing 210004,China;Department of Gynaecology,Women's Hospital of Nanjing Medical University,Nanjing Maternity and Child Health Care Hospital,Nanjing 210004,China)

机构地区：[1]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 [2]南京医科大学附属妇产医院南京市妇幼保健院妇科,江苏南京210004

出　　处：《中国介入影像与治疗学》2022年第11期683-686,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：江苏省妇幼保健协会科研项目(FYX202010)。

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。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.

关 键 词：子宫腺肌病 子宫动脉 栓塞 治疗性 治疗结果 

分 类 号：R711.74[医药卫生—妇产科学] R815[医药卫生—临床医学]