磁共振引导高强度聚焦超声与子宫动脉栓塞治疗子宫肌瘤的比较：系统文献回顾和荟萃分析。
Comparison of magnetic resonance-guided high-intensity focused ultrasound with uterine artery embolization for the treatment of uterine myoma: A systematic literature review and meta-analysis.
机构信息
Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, Kaohsiung Medical University, Taiwan.
Department of Obstetrics and Gynecology, School of Medicine, Kaohsiung Medical University, Taiwan; Department of Obstetrics and Gynecology, Connecticut Health Network, The University of Vermont Larner College of Medicine, Danbury, Connecticut, USA.
出版信息
Taiwan J Obstet Gynecol. 2020 Sep;59(5):691-697. doi: 10.1016/j.tjog.2020.07.012.
OBJECTIVE
This study aimed to compare the outcomes of magnetic resonance-guided (MR-g) high-intensity focused ultrasound (HIFU) with uterine artery embolization (UAE) for the treatment of uterine myoma.
MATERIALS AND METHODS
A systematic literature review and meta-analysis was conducted using database searches of Medline, Cochrane, EMBASE, and Google Scholar. Articles were searched through March 25, 2020. Outcomes of interest were Symptom Severity Score (SSS), Health-related Quality of Life (HRQoL), re-intervention rate, and rate of adverse reactions in patients with uterine myoma.
RESULTS
Four studies were included with a total of 207 patients with uterine myomas who received MR-g HIFU and 201 who received UAE. UAE was associated with a greater reduction in SSS, improved HRQoL, and a significantly lower re-intervention rate compared with MR-g HIFU in 3 of 4 included studies. No significant differences were found in the incidence and severity of adverse events between treatment arms in one study, but differences were observed in the percentage of adverse reactions in another.
CONCLUSION
Published evidence suggests that the efficacy of MR-g HIFU may not be superior to that of UAE in the treatment of uterine myoma.
目的
本研究旨在比较磁共振引导（MR-g）高强度聚焦超声（HIFU）与子宫动脉栓塞术（UAE）治疗子宫肌瘤的疗效。
材料与方法
采用 Medline、Cochrane、EMBASE 和 Google Scholar 数据库检索，对 2020 年 3 月 25 日前发表的文献进行系统评价和荟萃分析。纳入的研究对象为接受 MR-g HIFU 或 UAE 治疗的子宫肌瘤患者。主要结局指标为症状严重程度评分（SSS）、健康相关生活质量（HRQoL）、再次干预率和不良反应发生率。
结果
共纳入 4 项研究，总计 207 例接受 MR-g HIFU 治疗的子宫肌瘤患者和 201 例接受 UAE 治疗的患者。在 4 项研究中的 3 项研究中，UAE 组在 SSS 评分降低、HRQoL 改善和再次干预率方面均优于 MR-g HIFU 组。在 1 项研究中，两组治疗后不良反应的发生率和严重程度无显著差异，但在另一项研究中，不良反应的百分比存在差异。
结论
目前的研究结果提示，在治疗子宫肌瘤方面，MR-g HIFU 的疗效可能不如 UAE。
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