Spies James B, Myers Evan R, Worthington-Kirsch Robert, Mulgund Jyotsna, Goodwin Scott, Mauro Matthew
Department of Radiology, Georgetown University Hospital, Washington, DC 20007-2113, USA.
Obstet Gynecol. 2005 Dec;106(6):1309-18. doi: 10.1097/01.AOG.0000188386.53878.49.
To investigate the change in symptom severity and health-related quality of life among patients treated with uterine artery embolization for leiomyomata.
Using the Fibroid Registry for Outcomes Data (FIBROID), a multicenter, prospective, voluntary registry of patients undergoing uterine embolization for leiomyomata, we studied changes in symptom status, health-related quality of life, subsequent care, menstrual status, and satisfaction with outcome. Health-related quality-of-life and symptom status were measured using the Uterine Fibroid Symptom and Quality of Life, a leiomyoma-specific questionnaire. Summary statistics were used to describe the data set and multivariate analyses to determine predictors of outcome at 12 months.
Of 2,112 eligible patients, follow-up data were obtained on 1,797 (85.1%) at 6 months and 1,701 (80.5%) at 12 months. At 12 months, the mean symptom score had improved from 58.61 to 19.23 (P < .001), whereas 5.47% of patients had no improvement. The mean health-related quality-of-life score improved from 46.95 to 86.68 (P < .001), whereas 5.0% did not improve. In the first year after embolization, hysterectomy was performed in 2.9% of patients, with 3.6% requiring gynecologic interventions by 6 months and an additional 5.9% between 6 and 12 months. Amenorrhea as a result of embolization occurred in 7.3% of patients. Of these, 86% were age 45 or older. Most patients were satisfied with their outcome (82% strongly agree or agree). Predictors of a greater symptom change score include smaller leiomyoma size, submucosal location, and presenting symptom of heavy menstrual bleeding.
Uterine embolization results in substantial symptom improvement for most patients, with hysterectomy required in only 2.9% of patients in the first 12 months after therapy.
研究子宫肌瘤患者接受子宫动脉栓塞治疗后症状严重程度及健康相关生活质量的变化。
利用子宫肌瘤结局数据登记处（FIBROID），这是一个多中心、前瞻性、自愿参与的子宫肌瘤子宫栓塞患者登记处，我们研究了症状状态、健康相关生活质量、后续治疗、月经状态及对结局的满意度的变化。使用子宫肌瘤症状与生活质量这一特定于平滑肌瘤的问卷来测量健康相关生活质量和症状状态。汇总统计用于描述数据集，多变量分析用于确定12个月时结局的预测因素。
在2112例符合条件的患者中，6个月时获得了1797例（85.1%）的随访数据，12个月时获得了1701例（80.5%）的随访数据。12个月时，平均症状评分从58.61改善至19.23（P <.001），而5.47%的患者无改善。平均健康相关生活质量评分从46.95提高至86.68（P <.001），而5.0%的患者未改善。栓塞后的第一年，2.9%的患者接受了子宫切除术，6个月时3.6%的患者需要妇科干预，6至12个月期间另有5.9%的患者需要干预。栓塞导致闭经的患者占7.3%。其中，86%的患者年龄在45岁及以上。大多数患者对其结局满意（82%强烈同意或同意）。症状变化评分更高的预测因素包括较小的平滑肌瘤大小、黏膜下位置以及月经过多的表现症状。
子宫栓塞术使大多数患者的症状得到显著改善，治疗后的前12个月内仅2.9%的患者需要接受子宫切除术。
