Gao Yu, Jiang Fang, Wang Xinbo
Department of Obstetrics and Gynecology, Liangxiang Hospital Affiliated to Capital Medical University Beijing 102401, P. R. China.
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Beijing 100730, P. R. China.
Int J Clin Exp Med. 2015 Jun 15;8(6):8749-57. eCollection 2015.
This study is to compare the outcomes of tri-acryl gelatin microspheres (TAGM) and polyvinyl alcohol (PVA) in the treatment of uterine myomas with uterine artery embolization (UAE). Meta-analysis was performed by electronic literature searches from databases including Cochrane Central Register of Controlled Trials, PubMed, EMBASE and meta Register of Controlled Trials for studies published prior to December 2014. Randomized controlled trials comparing TAGM and PVA treating uterine myomas were included in the analysis. Information retrieved from each study included study design, number of participants, study settings, patient characteristics, sample size, follow-up duration and outcomes. Imaging outcomes and clinical outcomes were the main criteria for the evaluation of the included studies. Twenty-eight articles published from 1966 to December 2014 were retrieved through database searching and other sources. After initial screening and assessment, five randomized controlled trials, including 309 women with uterine myomas, met the inclusion criteria. In both imaging and clinical outcomes, TAGM group showed superior or similar effects than PVA group. The results showed more number of patients with significant tumor enhancement, greater mean change in tumor volume, greater mean changes in symptom score and QOL score in TAGM group compared with PVA group, with significant differences. TAGM and PVA groups had similar uterine volume, mean changes in bleeding score and pain score. TAGM is better than PVA as an embolic agent in the treatment of uterine myomas with UAE.
本研究旨在比较用子宫动脉栓塞术(UAE)治疗子宫肌瘤时三丙烯酸明胶微球(TAGM)与聚乙烯醇(PVA)的治疗效果。通过电子文献检索进行荟萃分析,检索的数据库包括Cochrane对照试验中心注册库、PubMed、EMBASE和对照试验荟萃注册库,检索截至2014年12月发表的研究。纳入分析的是比较TAGM和PVA治疗子宫肌瘤的随机对照试验。从每项研究中检索到的信息包括研究设计、参与者数量、研究背景、患者特征、样本量、随访时间和治疗效果。影像结果和临床结果是评估纳入研究的主要标准。通过数据库检索及其他来源,检索到1966年至2014年12月发表的28篇文章。经过初步筛选和评估,5项随机对照试验符合纳入标准,共纳入309例子宫肌瘤患者。在影像和临床结果方面,TAGM组均显示出比PVA组更好或相似的效果。结果显示,与PVA组相比,TAGM组有更多患者出现明显的肿瘤强化,肿瘤体积的平均变化更大,症状评分和生活质量评分的平均变化更大,差异有统计学意义。TAGM组和PVA组的子宫体积、出血评分和疼痛评分的平均变化相似。在UAE治疗子宫肌瘤中,TAGM作为栓塞剂比PVA更好。