子宫动脉栓塞治疗子宫肌瘤的生命质量评价

目的　评价子宫动脉栓塞治疗子宫肌瘤的生命质量变化 ,并与手术治疗相比较。方法按照完全随机对照研究方法 ,将子宫肌瘤患者分为子宫动脉栓塞组和手术治疗组 ,术前和术后 6个月进行生命质量问卷调查 ,分析治疗前后 2组患者生命质量的变化。结果　 2 79例症状性子宫肌瘤患者符合标准进入本研究 ,其中栓塞组 1 39例 ,手术组 1 4 0例。 2 1 8例患者 (栓塞组 1 1 8例 ,手术组1 0 0例 )完成术后 6个月的生命质量问卷。栓塞组术后的生命质量各因子评分均较术前明显提高 ,差异均有非常显著性意义 (P <0 0 0 1 ) ,而手术组术后除性生活评分与术前比较差异无显著性意义外 ,其他因子评分与术前相比差异均有非常显著性意义 (P <0 0 0 1 ) ;治疗前后生命质量评分差值两组患者相比较 ,术后性生活、一般健康状况、精力、情感职能和精神健康和健康变化等因子评分差值两组差异均有显著性意义 (P <0 0 0 1 ) ,栓塞组高于手术组。结论　子宫动脉栓塞比手术治疗更能提高子宫肌瘤患者的术后生命质量

The evaluation of quality of life associated with uterine artery embolization in the treatment of leiomyomas

Objective To evaluate the change in quality of life associated with uterine leiomyoma embolization in comparison with surgical treatment. Methods In a consecutive prospective, randomized and controlled study, the patients with symptomatic uterine leiomyomas in hospital were randomly assigned to uterine artery embolization group (UAEG) and surgical treatment group (STG) from January 2000 to February 2001. Quality of life of patients was investigated with the uterine leiomyomas symptom questionnaire and SF 36 Chinese questionnaire before and 6 months after the procedure in two groups. The changes of quality of life scores from baseline to 6 months were analyzed. Results There were 279 patients (140 of STG, 139 of UAEG) with symptomatic uterine leiomyomas who entered the study. 218 (118 of UAEG, 100 of STG) cases completed the 6 month questionnaires. In UAEG, the scores of quality of life in all instances improved at follow up ( P <0 001). In STG, the mean scores of quality of life also improved at follow up assessment except the scores of sexual function items( P <0 001). The mean change scores from baseline to 6 months in sexual function, general health, vitality, role emotional, mental health, and reported health transition were statistically significant between UAEG and STG ( P <0 001), and the former were higher than the latter. Conclusion The treatment of uterine artery embolization for uterine leiomyomas is better than surgical therapy on the improvement of quality of life.