Razavi Mahmood K, Hwang Gloria, Jahed Ayda, Modanlou Shohreh, Chen Bertha
Department of Vascular and Interventional Radiology, H-3651, Stanford University Vascular Center, 300 Pasteur Dr., CA 94305, USA.
AJR Am J Roentgenol. 2003 Jun;180(6):1571-5. doi: 10.2214/ajr.180.6.1801571.
The purpose of this study was to compare treatment efficacy and complications of abdominal myomectomy with those of uterine fibroid embolization in women with symptomatic uterine fibroids.
We analyzed the outcomes of 111 consecutive patients who underwent abdominal myomectomy (n = 44) or fibroid embolization (n = 67) over a 30-month period. The mean ages of the two groups were 37.7 years (range, 28-48 years) and 44.2 years (range, 31-56 years), respectively. A questionnaire and review of medical records assessed all procedure-related complications and changes in symptoms. Length of hospital stay, time until resumption of daily activities, and pain medication requirements after the procedure were also analyzed.
Follow-up times for the myomectomy and embolization groups were 14.6 and 14.3 months, respectively. The respective observed success rates in abdominal myomectomy and uterine fibroid embolization patients were 64% versus 92% for menorrhagia (p < 0.05), 54% versus 74% for pain (not significant), and 91% versus 76% for mass effect (p < 0.05). The complication rates were 25% (abdominal myomectomy) and 11% (uterine fibroid embolization) (p < 0.05). The respective secondary end points for the two procedures were 2.9 versus 0 days mean hospital stay, 8.7 versus 5.1 days of narcotics use, and 36 versus 8 days until resumption of normal activities. These differences were all statistically significant.
Uterine fibroid embolization is a less invasive and safer treatment option in women with symptomatic leiomyomas than myomectomy. Menorrhagia may be better controlled with embolization, and myomectomy may be a better option in patients with mass effect. Both procedures were equally effective in controlling pain.
本研究旨在比较腹式子宫肌瘤切除术与子宫纤维瘤栓塞术对有症状子宫肌瘤女性的治疗效果及并发症情况。
我们分析了在30个月期间连续接受腹式子宫肌瘤切除术（n = 44）或纤维瘤栓塞术（n = 67）的111例患者的治疗结果。两组的平均年龄分别为37.7岁（范围28 - 48岁）和44.2岁（范围31 - 56岁）。通过问卷调查和病历回顾评估所有与手术相关的并发症及症状变化。还分析了住院时间、恢复日常活动所需时间以及术后止痛药物需求。
子宫肌瘤切除术组和栓塞术组的随访时间分别为14.6个月和14.3个月。腹式子宫肌瘤切除术和子宫纤维瘤栓塞术患者中，月经过多的观察成功率分别为64%和92%（p < 0.05），疼痛方面分别为54%和74%（无显著差异），肿块效应方面分别为91%和76%（p < 0.05）。并发症发生率分别为25%（腹式子宫肌瘤切除术）和11%（子宫纤维瘤栓塞术）（p < 0.05）。两种手术的次要终点分别为平均住院时间2.9天对0天、使用麻醉剂时间8.7天对5.1天、恢复正常活动时间36天对8天。这些差异均具有统计学意义。
对于有症状平滑肌瘤的女性，子宫纤维瘤栓塞术是一种比子宫肌瘤切除术侵入性更小且更安全的治疗选择。栓塞术对月经过多的控制可能更好，而对于有肿块效应的患者，子宫肌瘤切除术可能是更好的选择。两种手术在控制疼痛方面同样有效。
