【摘要】 目的系统评价子宫动脉介入栓塞术(UAE)对比手术治疗有症状子宫肌瘤的安全性及有效性。方法计算机检索The Cochrane Library、Pub Med、Embase、Web of Science、CNKI和Wanfang Data等,检索时限均为从建库至2014年7月,查找UAE与手术比较的治疗有症状子宫肌瘤的随机对照试验(RCT),并追溯纳入文献的参考文献。由2位研究者按照纳入与排除标准独立筛选文献、提取资料并评价质量后,采用Rev Man 5.2软件进行meta分析。结果最终纳入6个RCT,共732例患者。meta分析结果显示:住院时间和恢复时间UAE较手术治疗子宫肌瘤短;健康相关的生活质量、患者满意度、术中并发症、1年内的主要并发症及肌瘤复发率,两者差异无统计学意义;1年内的次要并发症和需要进一步干预率(2年和5年)差异有统计学意义,UAE比手术发生率高;受孕率和活产率差异有统计学意义,UAE比手术发生率低。结论与手术相比,UAE具有安全性好、效果佳、操作简便、易护理、创伤小、康复快、易被患者接受等优点,但是有需要接受再次干预治疗的风险。UAE对患者生育能力的影响、不同特性的栓塞剂对UAE疗效的影响及UAE对多发性子宫肌瘤的疗效,都需要进一步研究。更多还原

【Abstract】 Objective To systematically evaluate the safety and effectiveness of interventional uterine artery embolization(UAE) in treating symptomatic uterine fibroids by comparing it with surgical therapy.Methods Computer retrieval of the Cochrane Library,Pub Med,EMbase,Web of Science,China National Knowledge Internet(CNKI),Wanfang data,etc.was conducted.The retrieval time was from the inception to July 2014.The academic papers that were related to the randomly controlled test(RCT) of UAE and surgical treatment for symptomatic uterine fibroids were collected,and the reference literatures were also searched for.Two reviewers screened the literatures according to the inclusion and exclusion criteria,the useful data were extracted and the qualities were evaluated.Meta-analysis was performed by using Rev Man 5.2 software.Results A total of 6 RCTs were finally obtained,including 732 patients in total.Meta-analysis indicated that both the hospitalization time and recovery time in UAE group were shorter than those in surgery group.No significant differences in health-related quality of life,patient’s satisfaction,intra-operation complications,the recurrence rate and main complications within one year existed between UAE group and surgery group; while the differences in the incidence of minor complications within one year and the need of further intervention rate during 2-5 years were statistically significant,the occurrence of these minor complications in UAE group being higher than that in the surgery group.The pregnancy rate and live-birth rate in UAE group were significantly lower than those in the surgery group.Conclusion Compared with surgery,UAE has many advantages,such as technically-safe,excellent therapeutic effect,simply-manipulated,easy-nursing,mini-invasive,quick-recovery and easily-accepted by patient,etc.although there is risk of receiving intervention treatment again.The influence of UAE on the fertility,the influence of different embolic agents on the therapeutic effect of UAE,and the effectiveness of UAE for multiple uterine fibroids need to be further studied.更多还原