子宫肌瘤栓塞术：家庭医生继续医学教育更新内容
Uterine fibroid embolization: CME update for family physicians.
作者信息
Raikhlin Antony, Baerlocher Mark Otto, Asch Murray R
机构信息
Faculty of Medicine, University of Toronto, Ontario.
出版信息
Can Fam Physician. 2007 Feb;53(2):250-6.
OBJECTIVE
To review evidence supporting the use of uterine fibroid embolization (UFE) as an alternative to hysterectomy and myomectomy for managing uterine fibroids.
QUALITY OF EVIDENCE
MEDLINE was searched using the MeSH terms embolization, therapeutic; leiomyoma; treatment outcome; pregnancy; and clinical trials. Most published studies on use of UFE for management of uterine fibroids provide level II evidence.
MAIN MESSAGE
For 71% to 92% of patients, UFE is effective at alleviating fibroid-related symptoms. After UFE, fibroids are reduced in size by 42% to 83%. Patients' satisfaction with the procedure is high (>90%), and UFE is safe and has a low rate of major complications (1.25%). When compared with hysterectomy, UFE is associated with fewer major complications, shorter hospital stays, and faster recovery. Although successful pregnancy following UFE is possible, there is insufficient evidence to advocate use of UFE over myomectomy for management of uterine fibroids in women wishing to preserve fertility.
CONCLUSION
For treatment of symptomatic uterine fibroids, UFE is a safe and effective nonsurgical alternative to hysterectomy and myomectomy.
目的
回顾支持使用子宫纤维瘤栓塞术（UFE）作为子宫切除术和肌瘤切除术替代方法来治疗子宫肌瘤的证据。
证据质量
使用医学主题词“栓塞，治疗性的”“平滑肌瘤”“治疗结果”“妊娠”和“临床试验”检索MEDLINE。大多数已发表的关于使用UFE治疗子宫肌瘤的研究提供了二级证据。
主要信息
对于71%至92%的患者，UFE能有效缓解与肌瘤相关的症状。UFE术后，肌瘤体积缩小42%至83%。患者对该手术的满意度较高（>90%），且UFE安全，主要并发症发生率较低（1.25%）。与子宫切除术相比，UFE的主要并发症更少、住院时间更短且恢复更快。尽管UFE术后成功妊娠是可能的，但对于希望保留生育能力的子宫肌瘤女性患者，没有足够证据支持使用UFE而非肌瘤切除术来治疗子宫肌瘤。
结论
对于有症状的子宫肌瘤治疗，UFE是子宫切除术和肌瘤切除术安全有效的非手术替代方法。
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