超声引导下微波消融治疗症状性子宫肌瘤：系统评价和荟萃分析。
Ultrasound-guided Microwave Ablation in the Management of Symptomatic Uterine Myomas: A Systematic Review and Meta-analysis.
机构信息
National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China (all authors).
National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China (all authors)..
出版信息
J Minim Invasive Gynecol. 2021 Dec;28(12):1982-1992. doi: 10.1016/j.jmig.2021.06.020. Epub 2021 Jun 28.
OBJECTIVE
This systematic review and meta-analysis aimed to evaluate the clinical effects and safety of ultrasound-guided microwave ablation (MWA) for the treatment of symptomatic uterine myomas.
DATA SOURCES
We searched PubMed, Web of Science Core Collection, Cochrane Library, Embase, Scopus, and Google Scholar for studies from January 2000 to January 2021.
METHODS OF STUDY SELECTION
We included all studies that reported the clinical outcomes of ultrasound-guided MWA in women with symptomatic uterine myomas. Two researchers conducted the study selection according to the screening criteria.
TABULATION, INTEGRATION, AND RESULTS: We evaluated the risk of bias and evidence quality using the Newcastle-Ottawa scale. Two researchers independently extracted information from the included studies. We extracted the standardized mean difference (SMD) and pooled proportion with a 95% confidence interval (CI) for the outcome measures of interest. A total of 10 studies representing 671 patients were included. The Uterine Fibroid Symptom and Quality of Life (UFS-QoL) questionnaire was used to assess the clinical effects. Compared with baseline, the UFS scores decreased significantly (SMD 3.37; 95% CI, 2.27-4.47; p <.001; reduction rate 65.9%), QoL scores increased significantly (SMD -3.12; 95% CI, -3.93 to -2.30; p <.001; rate of increase 72.0%), and hemoglobin concentration increased significantly (SMD -2.13; 95% CI, -3.44 to -0.81; p = .002; rate of increase 30.3%) at follow-up. The mean operation time was 34.48 minutes (95% CI, 22.82-46.13; p <.001). The rate of reduction in myoma volume after MWA was 85.3% (95% CI, 82.7%-88.0%, p <.001). No major adverse event was reported, and the incidence of minor adverse events was 21.1% (95% CI, 15.1%-27.0%, p <.001).
CONCLUSION
Ultrasound-guided MWA is an effective and safe minimally invasive therapy for symptomatic uterine myomas.
目的
本系统评价和荟萃分析旨在评估超声引导下微波消融（MWA）治疗有症状子宫肌瘤的临床效果和安全性。
数据来源
我们检索了 2000 年 1 月至 2021 年 1 月期间的 PubMed、Web of Science 核心合集、Cochrane 图书馆、Embase、Scopus 和 Google Scholar，以查找有关超声引导下 MWA 治疗有症状子宫肌瘤的临床结局的研究。两位研究人员根据筛选标准进行了研究选择。
研究选择
我们纳入了所有报告超声引导下 MWA 治疗有症状子宫肌瘤的女性临床结局的研究。两位研究人员根据筛选标准独立筛选了纳入研究。我们提取了感兴趣结局的标准化均数差（SMD）和合并比例及其 95%置信区间（CI）。共有 10 项研究纳入了 671 例患者。采用子宫肌瘤症状和生活质量（UFS-QoL）问卷评估临床效果。与基线相比，UFS 评分显著降低（SMD 3.37；95%CI，2.27-4.47；p<0.001；降低率 65.9%），生活质量评分显著提高（SMD-3.12；95%CI，-3.93 至-2.30；p<0.001；提高率 72.0%），血红蛋白浓度显著升高（SMD-2.13；95%CI，-3.44 至-0.81；p=0.002；提高率 30.3%）。随访时，平均手术时间为 34.48 分钟（95%CI，22.82-46.13；p<0.001）。MWA 后肌瘤体积缩小率为 85.3%（95%CI，82.7%-88.0%，p<0.001）。未报告重大不良事件，小不良事件发生率为 21.1%（95%CI，15.1%-27.0%，p<0.001）。
结论
超声引导下 MWA 是治疗有症状子宫肌瘤的一种有效且安全的微创治疗方法。
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