Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Am J Obstet Gynecol. 2011 Oct;205(4):317.e1-18. doi: 10.1016/j.ajog.2011.03.016. Epub 2011 Mar 16.
To summarize the evidence on short-, mid-, and long-term results up to 5 years of uterine artery embolization in comparison to surgery.
We searched the CENTRAL, MEDLINE and EMBASE databases for randomized clinical trials comparing uterine artery embolization with hysterectomy/myomectomy in premenopausal women with heavy menstrual bleeding caused by symptomatic uterine fibroids, written from September 1995 to November 2010. Two reviewers independently assessed methodologic quality and extracted data from included trials.
Four randomized controlled trials with a total of 515 patients were included. On the short-term, uterine artery embolization showed fewer blood loss, shorter hospital stay, and quicker resumption of work. Mid- and long-term results showed comparable health-related quality of life results and a higher reintervention rate in the uterine artery embolization group, whereas both groups were equally satisfied.
Uterine artery embolization has short-term advantages over surgery. On the mid- and long-term the benefits were similar, except for a higher reintervention rate after uterine artery embolization.
总结 5 年以内子宫动脉栓塞术与手术治疗相比的近期、中期和远期疗效证据。
我们检索了 CENTRAL、MEDLINE 和 EMBASE 数据库，纳入了 1995 年 9 月至 2010 年 11 月期间，比较因症状性子宫肌瘤导致月经过多的绝经前妇女采用子宫动脉栓塞术与子宫切除术/子宫肌瘤切除术治疗的随机临床试验。两位评价者独立评估了纳入研究的方法学质量并提取数据。
4 项随机对照试验共纳入 515 例患者。近期结果显示，子宫动脉栓塞术组术中出血量更少、住院时间更短、恢复工作更快。中期和远期结果显示，子宫动脉栓塞组的健康相关生活质量结果相当，但再干预率更高，而两组患者的满意度相当。
子宫动脉栓塞术在短期上优于手术治疗。从中期和长期来看，除了子宫动脉栓塞术治疗后的再干预率较高外，两种治疗方法的疗效相当。
