Meta-analysis Of The Efficacy Of Uterine Artery Embolization In The Treatment Of Adenomyosis In Chinese Population

Objective:Meta analysis method is adopted to assess uterine artery embolization(Uterine Artery Embolization,UAE)curative effect for the treatment of uterine adenomyosis in Chinese patients.The postoperative outcome indexes of the subjects were compared in order to provide evidence-based evidence for the clinical promotion of this therapy.Methods:Chinese databases including Wan Fang Database,CNKI Database and CBM database and English databasessuch as Embase,Pub Med,Cochrane Elibrary and so on were searched by computer and hand.Treatment evaluation was conducted for the final included literatures,Meta analysis of the extracted data was performed using Review Manager5.4,and publication bias evaluation was performed using Stata16.0.Results:Finally,15 literatures were included,including a total of 1300 patients with adenomyosis.The results of meta-analysis showed as follows: 1.Uterine volume reduction:Surgery group was better than UAE;There was no significant difference between UAE and HIFU.UAE works better than Gn RH-a.The difference between UAE and LNG-IUS was statistically significant,and the latter was more significant.2.Dysmenorrhea relief: UAE and surgery can both relieve dysmenorrhea,and there is no significant difference between them;UAE is better at relieving menstrual cramps than Gn RH-a.3.Increased hemoglobin:Hemoglobin after UAE treatment was higher than that after surgery,the difference was statistically significant,but sensitivity analysis showed that the results were not robust;The hemoglobin level after HIFU treatment was higher than that of UAE,and the difference was statistically significant.4.Sex hormone level: The difference between UAE and operation was statistically significant.E2 level after UAE treatment was higher than that after operation,and there was no significant difference between UAE and HIFU treatment.The difference between UAE and Gn RH-a after treatment was statistically significant,suggesting that E2 levels of UAE and Gn RH-a were higher in the former than in the latter.5.CA125value: UAE and operation can both reduce CA125 without significant difference;Both UAE and HIFU can reduce CA125 value,with the latter having a more significant effect.6.Menstrual volume PBAC score: UAE had better effect on reducing menstrual volume than surgery and Gn RH-a.7.Postoperative complications: There was a statistically significant difference in the incidence of postoperative complications between UAE and operation,suggesting that the incidence of postoperative complications in UAE was lower than that in operation.8.MMP content: There were statistically significant differences between UAE and MMP-2,MMP-3 and MMP-9 after surgical treatment,suggesting that UAE can better reduce MMP value.9.Length of hospital stay and intraoperative blood loss: There were statistically significant differences in length of hospital stay and intraoperative blood loss between UAE and operation,and UAE group was significantly less than operation group.Conclusion:Compared with surgery,UAE has the advantages of less influence on E2,more significant relief of menstrual volume,lower incidence of postoperative complications,better reduction of MMP value,shorter hospital stay,and less intraoperative blood loss.UAE has the same ability to improve dysmenorrhea and reduce CA125 as surgery.Compared with HIFU,UAE has no significant difference in ovarian function,and HIFU can restore hemoglobin more quickly and reduce CA125.Compared with Gn RH-a,UAE has the advantages of significantly reducing uterine volume,relieving dysmenorrhea,little influence on E2,better reducing CA125,and significantly reducing menstrual volume,but the postoperative FSH and LH levels are higher than those after Gn RH-a treatment.