Spies James B, Cornell Curt, Worthington-Kirsch Robert, Lipman John C, Benenati James F
Department of Radiology, Georgetown University Hospital, 3800 Reservoir Rd NW, CG 201, Washington, DC 20007-2197, USA.
J Vasc Interv Radiol. 2007 Feb;18(2):203-7. doi: 10.1016/j.jvir.2006.12.006.
To determine the long-term outcome of uterine fibroid therapy (UFE) using tris-acryl gelatin microspheres (TAGM).
This was a multicenter prospective study of patients undergoing UFE with TAGM, and during this phase of the study, the clinical outcomes 3 years after treatment were assessed. Measures of outcome included the Ruta Menorrhagia Questionnaire, patient self-assessments of symptoms and impact on activities, patient satisfaction and health-related quality of life as measured by the SF-12. Long-term re-intervention rates were also assessed. The data were analyzed at each interval compared to baseline using appropriate statistical tests.
Of the 102 patients enrolled, 96 patients had complete baseline data and of these, 69 (72%) had known outcomes at 3 years after treatment. Sixty-one patients (64%) completed long-term follow-up without major intervention. An additional 8 patients (8.3%) underwent fibroid surgery (7 hysterectomies and 1 myomectomy). Among those without intervention, at 3 years after treatment, the mean Ruta Questionnaire Score was 19.3, compared to 47.9 at baseline and 24.5 at 3 months (P <.01). At baseline, 57% of patients had extremely heavy bleeding, while only 2% had that complaint at 36 months. At 36 months, much or moderate improvement in pelvic pain occurred in 83% of patients, pelvic discomfort in 83%, and urinary problems in 69% and 84% were moderately or very satisfied with their outcome.
Over the long-term, UFE using TAGM is effective and safe, with high levels of durable symptom control, improved health-related quality of life and patient satisfaction.
确定使用三丙烯酸明胶微球(TAGM)进行子宫肌瘤栓塞治疗(UFE)的长期疗效。
这是一项对接受TAGM-UFE治疗患者的多中心前瞻性研究,在此研究阶段,评估了治疗后3年的临床疗效。疗效指标包括月经过多问卷、患者对症状及对活动影响的自我评估、患者满意度以及通过SF-12测量的健康相关生活质量。还评估了长期再次干预率。使用适当的统计检验将每个时间间隔的数据与基线进行比较分析。
在纳入的102例患者中,96例患者有完整的基线数据,其中69例(72%)在治疗后3年有已知结局。61例患者(64%)在未进行重大干预的情况下完成了长期随访。另外8例患者(8.3%)接受了子宫肌瘤手术(7例子宫切除术和1例肌瘤切除术)。在未进行干预的患者中,治疗后3年,月经过多问卷平均得分19.3,而基线时为47.9,3个月时为24.5(P<.01)。基线时,57%的患者有极大量出血,而在36个月时只有2%的患者有此主诉。在36个月时,83%的患者盆腔疼痛有很大或中度改善,盆腔不适有改善的占83%,69%的患者泌尿系统问题有改善,84%的患者对其结局中度或非常满意。
长期来看,使用TAGM进行UFE是有效且安全的,能持久控制症状,改善健康相关生活质量并提高患者满意度。