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【medical-news】子宫动脉栓塞使子宫肌瘤患者恢复
NEW YORK (Reuters Health) Jan 24 - As a treatment for symptomatic uterine fibroids, uterine artery embolization (UAE) results in faster recovery than conventional surgical methods, but a minority of patients will require further treatment, Scottish researchers report.
"The results of our study make clear that the choice between surgery and UAE for symptomatic uterine fibroids involves trade-offs," study author Dr. Jonathan G. Moss, from the Gartnavel Hospital in Glasgow, UK, and colleagues note. "Longer-term follow-up is necessary, with attention to the need for repeated intervention, to inform future decision making."
The findings, which appear in The New England Journal of Medicine for January 25, stem from a study of 157 patients who were randomized in a 2:1 ratio to undergo UAE or surgery. Of the 51 surgeries performed, 43 were hysterectomies and 8 were myomectomies.
The median duration of hospitalization was much shorter in the UAE group: 1 vs. 5 days with surgery (p < 0.001). Similarly, UAE-treated patients returned to work significantly sooner than did surgical patients (p < 0.001).
However, symptom scores at 1 year were better in the surgical group than in the UAE group, but no significant differences in quality of life were noted, the authors report. The major adverse event rate during the first year was higher in the surgical group (20% vs. 12%), but the difference fell short of statistical significance.
Twenty-one treatment failures (21%) requiring retreatment occurred in the UAE group, including 10 during the first year and 11 subsequently. By contrast, in the surgical group, just one failure occurred and that was a conversion from myomectomy to hysterectomy at the time of the initial operation.
In a related editorial, Dr. Togas Tulandi, from McGill University in Montreal, comments that a key factor in selecting a fibroid treatment is whether the patient desires to become pregnant. At present, the effect of UAE on pregnancy is unclear and, therefore, "myomectomy should be the first line of treatment for women with symptomatic uterine fibroids who wish to conceive."
For women with surgical risk factors, such as previous laparotomy or diffuse uterine fibroids, myomectomy may not be feasible, and embolization should be considered, Dr. Tulandi adds. Also, for some women, hysterectomy is a reasonable option.
N Engl J Med 2007;356:360-370,411-413.
http://www.medscape.com/viewarticle/551221 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。
Uterine Artery Embolization for Fibroids Speeds Recovery
子宫动脉栓塞有助于子宫肌瘤迅速恢复。
NEW YORK (Reuters Health) Jan 24 - As a treatment for symptomatic uterine fibroids, uterine artery embolization (UAE) results in faster recovery than conventional surgical methods, but a minority of patients will require further treatment, Scottish researchers report.
纽约（路透视健康频道）1月24日。 苏格兰的研究人员报道，和传统的手术相比，作为治疗有症状的子宫平滑肌瘤方法：子宫动脉栓塞（UAE）能够快速恢复，但是少部分患者需要进一步的治疗。
"The results of our study make clear that the choice between surgery and UAE for symptomatic uterine fibroids involves trade-offs," study author Dr. Jonathan G. Moss, from the Gartnavel Hospital in Glasgow, UK, and colleagues note. "Longer-term follow-up is necessary, with attention to the need for repeated intervention, to inform future decision making."英国格拉斯哥的Gartnavel医院的Jonathan G Moss博士说：“我们的结果明确了在手术和UAE中，如何选择方法治疗症状性子宫肌瘤，由于部分患者还需要再次治疗因此还需要长期随访以指导将来的决策选择。”
The findings, which appear in The New England Journal of Medicine for January 25, stem from a study of 157 patients who were randomized in a 2:1 ratio to undergo UAE or surgery. Of the 51 surgeries performed, 43 were hysterectomies and 8 were myomectomies.
这个发现在1月25日的新英格兰医学杂志上发表，基于157名病人随机分组为2：1进行UAE或者手术，其中，51名进行手术，43行子宫切除术、8人行子宫肌瘤切除术。
The median duration of hospitalization was much shorter in the UAE group: 1 vs. 5 days with surgery (p < 0.001). Similarly, UAE-treated patients returned to work significantly sooner than did surgical patients (p < 0.001).
和手术组相比UAE组患者的平均住院日明显减少，分别为1天和5天（p < 0.001），UAE治疗组患者比手术组返回工作要早（p < 0.001）。
However, symptom scores at 1 year were better in the surgical group than in the UAE group, but no significant differences in quality of life were noted, the authors report. The major adverse event rate during the first year was higher in the surgical group (20% vs. 12%), but the difference fell short of statistical significance.
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作者:admin@医学,生命科学 2011-02-27 05:11
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