异常子宫出血药物治疗和子宫切除术治疗比较的随机试验:药物或手术(Ms)的资源使用

• 作 者: Showstack J. Learman L.A. 张旸
• 机 构: Department of Medicine University of California San Francisco CA United States Dr,
• 出 处: 世界核心医学期刊文摘(妇产科学分册)
• 发表日期: 2006年09期
• 关键词: 异常子宫出血 子宫切除术 药物治疗 随机试验 手术 子宫切除手术 醋酸甲羟孕酮 临床结局 资源使用情况 随机对照试验

Objective: This study was undertaken to compare resource use outcomes for participants in the Medicine or Surgery (Ms)- randomized trial. Study design: In a randomized controlled trial, we compared resources used during a 24- month follow-up period by women with abnormal uterine bleeding who were randomly assigned to either expanded medical treatment or hysterectomy. Results: Women randomly assigned to hysterectomy used significantly more resources (medicine = ＄ 4479, hysterectomy = ＄ 6777; P = .03), with almost all the difference caused by the hysterectomy procedure. Fifty- three percent of women randomly assigned to medicine had a hysterectomy during the follow- up period; women who were able to continue on medical therapy had mean total resource use of ＄ 2595 compared with ＄ 6128 for medicine patients who eventually had surgery. Conclusion: For women with abnormal uterine bleeding refractory to cyclic medroxyprogesterone acetate, compared with expanded medical treatment, hysterectomy increases resource use significantly and results in better clinical and 6- month quality- of- life outcomes.

Objective: This study was undertaken to compare resources use outcomes for participants in the Medicine or Surgery (Ms) - randomized trial. Study design: In a randomized controlled trial, we compared resources used during a 24- month follow-up period by women with abnormal uterine bleeding who was randomly assigned to either expanded medical treatment or hysterectomy. Results: Women randomly assigned to hysterectomy used significantly more resources (medicine = $ 4479, hysterectomy = $ 6777; P = .03), with almost all the difference caused by the hysterectomy procedure. Fifty- three percent of women randomly assigned to medicine had a hysterectomy during the follow- up period; women who were able to continue on on medical therapy had mean total resource use of $ 2595 compared with $ 6128 for medicine patients who eventually had surgery. Conclusion: For women with abnormal uterine bleeding refractory to cyclic medroxyprogesterone acetate, compared with expanded medical treatment, hys terectomy increases resource use significantly and results in better clinical and 6- month quality- of- life outcomes.