de Bruijn Annefleur M, Smink Marieke, Hehenkamp Wouter J K, Nijenhuis Robbert J, Smeets Albert J, Boekkooi Focco, Reuwer Paul J H M, Van Rooij Willem J, Lohle Paul N M
Department of Gynecology, VU Medical Centre, De Boelelaan 1117, 1007MB, Amsterdam, The Netherlands.
Department of Gynecology, Elisabeth Tweesteden Ziekenhuis, Tilburg, The Netherlands.
Cardiovasc Intervent Radiol. 2017 Sep;40(9):1344-1350. doi: 10.1007/s00270-017-1686-1. Epub 2017 May 17.
The purpose of this study was to assess clinical outcomes 7 years after uterine artery embolization (UAE) in the treatment of symptomatic adenomyosis.
In this prospective cohort study, one specialized hospital in the Netherlands recruited patients with symptomatic adenomyosis or adenomyosis in combination with fibroids for UAE. The 7-year post-intervention outcomes were health-related quality of life (HRQOL), symptom severity scores (SSS), satisfaction, menopause and re-interventions.
Twenty-nine patients with adenomyosis (15 with fibroids) were treated with UAE between September 2006 and January 2010. The 7-year questionnaire was mailed in November 2016. The mean follow-up was 95 months (SD 9.0) at a mean age of 50 (SD 5.4). Questionnaires were returned by 24/29 patients (83%). The remaining five patients were contacted through telephone. One of these patients was untraceable. Seven years after treatment 5 of 28 patients (18%) underwent a secondary hysterectomy. The HRQOL and SSS scores as measured by UFS-QOL at 3 months after UAE showed significant improvement of -57 points (score: 15) and +40 points (score: 91), respectively. These scores remained comparable stable up unto 7 years. The SSS showed a significant difference of 17 points (0-100) in favor of the adenomyosis in combination with fibroids group (p = 0.020). Menopause was reported by 10/28 patients (36%). Twenty-one of 29 (72%) patients declared to be at least fairly satisfied about UAE.
After 7 years of follow-up, in 82% of UAE-treated patients with symptomatic adenomyosis a hysterectomy was avoided.
本研究旨在评估子宫动脉栓塞术（UAE）治疗症状性子宫腺肌病7年后的临床结局。
在这项前瞻性队列研究中，荷兰一家专科医院招募了患有症状性子宫腺肌病或合并子宫肌瘤的子宫腺肌病患者接受UAE治疗。干预后7年的结局指标包括健康相关生活质量（HRQOL）、症状严重程度评分（SSS）、满意度、绝经情况和再次干预情况。
2006年9月至2010年1月期间，29例子宫腺肌病患者（15例合并子宫肌瘤）接受了UAE治疗。2016年11月邮寄了7年随访问卷。平均随访时间为95个月（标准差9.0），平均年龄为50岁（标准差5.4）。24/29例患者（83%）返回了问卷。其余5例患者通过电话联系。其中1例患者无法联系到。治疗7年后，28例患者中有5例（18%）接受了二次子宫切除术。UAE术后3个月时，通过UFS-QOL测量的HRQOL和SSS评分分别显著改善了-57分（评分：15）和+40分（评分：91）。这些评分在7年内保持相对稳定。SSS显示合并子宫肌瘤的子宫腺肌病组有17分（0-100）的显著差异（p = 0.020）。28例患者中有10例（36%）报告绝经。29例患者中有21例（72%）表示对UAE至少相当满意。
经过7年随访，82%接受UAE治疗的症状性子宫腺肌病患者避免了子宫切除术。
