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关于传统子宫肌瘤栓塞术(ufe)及部分ufe后自然受孕活产的研究-ag捕鱼平台

文字: 2017-8-2    浏览次数:926    

spontaneous pregnancy with a live birth after conventional and partial uterine fibroid embolization

关于传统子宫肌瘤栓塞术(ufe)及部分ufe后自然受孕活产的研究

 

purpose

to determine pregnancy rates after conventional and partial uterine fibroid embolization (ufe).

本研究旨在探索传统子宫肌瘤栓塞术及局部子宫肌瘤栓塞术后患者受孕率。

materials and methods

the study received institutional review board approval and all patients gave written informed consent. a retrospective analysis of data collected prospectively was performed between june 2004 and june 2014 in a cohort of 359 women (mean age, 35.9 years ±4.8) with uterine fibroids and/or adenomyosis who were unable to conceive. the median follow-up period was 69 months (range, 6–126 months). under local anesthesia, both uterine arteries were embolized. in 160 patients, partial embolization was intentionally performed to preserve fertility, which may be decreased after conventional ufe. in partial ufe, only the small arterial vessels to the fibroids were embolized, leaving the large vessels of the fibroids patent. the kaplan-meier method and cox regression were used for the statistical analysis.

本研究通过伦理委员会审查,且所有患者均签署知情同意书。该项研究队列共纳入就诊于2004年6月至2014年6月的359位女性患者(平均年龄35.9±4.8岁),所有患者均患有子宫肌瘤或子宫腺肌症且无法受孕。将患者信息收集后进行回顾性分析,中位随访时间为69个月(6-126个月)。患者均在局麻下接受双侧子宫动脉栓塞术(ufe)。由于传统子宫动脉栓塞术可能会降低生育能力,故对于其中160例患者实施了部分子宫动脉栓塞术。实施部分ufe时,保留大血管,只对供给肌瘤的小动脉进行栓塞。

results

during follow-up, 149 women became pregnant, 131 women had live births, and 16 women had several pregnancies, resulting in a total of 150 live newborns. it was the first pregnancy for 85.5% (112 of 131) of women. spontaneous pregnancy rates at 1 year and 2 years after ufe were 29.5% and 40.1%, espectively. the probability of successful pregnancy with live birth at 1 year and 2 years was 24.4% and 36.7%, respectively. clinical success for fibroid-related symptoms was 78.6%(282 of 359). a dominant submucosal fibroid and ischemia greater than or equal to 90% had greater likelihood of spontaneous pregnancy. complication rates inpatients treated with partial ufe (14.6%) were not greater than rates inpatients treated with conventional ufe (23.1%, p = .04).

随访中,共有149例患者受孕,131例产下活婴,16例多次妊娠,共计生产新生儿150名。首次受孕的患者占比85.5% (112/131)。ufe后1年及2年自然受孕率分别为 24.4%及36.7%,肌瘤相关症状控制率为78.6%  (282/359)。粘膜下肌瘤及缺血大于等于90%,提示自然受孕的概率较高。接受部分ufe的患者并发症发生率(14.6%)并不高于传统ufe(23.1%, p = 0.04)。

conclusion

conventional and partial ufe may be safe and effective outpatient procedures for women with uterine fibroids who want to conceive.

对于患有子宫肌瘤且有妊娠意愿的患者,传统及部分子宫肌瘤栓塞术可能均是有效且安全的门诊手术。