子宫动脉栓塞术与甲氨蝶呤治疗剖宫产术后子宫瘢痕妊娠疗效对比的Meta分析

发布时间：2018-02-13 14:46

本文关键词： 剖宫产术子宫瘢痕妊娠子宫动脉栓塞 Meta分析　出处：《妇产与遗传(电子版)》2016年04期 　论文类型：期刊论文

【摘要】：目的系统评价子宫动脉栓塞在剖宫产术后子宫瘢痕妊娠中的疗效。方法以动脉栓塞(arterial embolization)、子宫瘢痕妊娠(cesarean scar pregnancy,CSP)、随机对照实验(randomized controlled trial,RCT)、剖宫产(cesarean section)、甲氨蝶呤(methotrexate,MTX)等检索词全面检索Cochrane图书馆、Embase、Pub Med,并检索中国生物医学文献数据库(CBM)、相关期刊论文(VIP)、中文科技期刊数据库(CNKI)和万方数据库(Wanfang Data),检索时间截止至2015年5月,并将符合纳入标准的文献按照Cochrane协作网推荐的方法进行系统评价。结果共纳入的6篇文献,4篇比较子宫动脉栓塞术与MTX疗效;2篇比较子宫动脉化疗栓塞术与MTX疗效,其中1篇比较不同栓塞剂(明胶海绵及聚乙烯醇颗粒)化疗栓塞和单纯MTX的疗效。系统评价结果显示子宫动脉(化疗)栓塞组住院时间(MD-28.29 d,95%CI:-31.08~-25.51,P0.00001)、出血量(MD-448.47 m L,95%CI:-513.57~-383.37,P0.00001)、血β-HCG恢复正常时间(MD-20.167 d,95%CI:-33.01~-7.32,P=0.002)及治疗成功率(RR:1.35,95%CI:1.05~1.73,P=0.02)均优于甲氨蝶呤组,两组月经恢复时间(MD-2.93 d,95%CI:-6.03~0.16,P=0.06)、副反应发生率(RR:0.96,95%CI:0.51~1.82,P=0.90)无统计学意义。结论子宫动脉栓塞术治疗剖宫产术后瘢痕妊娠疗效确切。
[Abstract]:Objective to evaluate the efficacy of uterine artery embolization in uterine scar pregnancy after cesarean section. Methods artery embolization with arterial embolization of uterine scar pregnancy, uterine scar pregnancy Cesarean scar pregnancyn controlled, randomized controlled trialator RCTT, cesarean sectionation, methotrexate methotrexate. A comprehensive search of Cochrane Library Embase Pub Medand, and the search of Chinese Biomedical Literature Database (CBM), Chinese Journal Full-text Database (Cochrane), Chinese Journal of Science and Technology Database (CNKI) and Wanfang data Base (Wanfang data) were conducted. The search time was up to May 2015. According to the method recommended by Cochrane Cooperative Network, a systematic evaluation was carried out on the literature according to the inclusion criteria. Results there were 6 articles, 4 articles, comparing uterine artery embolization with MTX and 2 articles comparing uterine arterial chemoembolization with MTX. One of them compared the effects of different embolization agents (gelfoam and polyvinyl alcohol granules) on chemoembolization and simple MTX. The results of systematic evaluation showed that the hospitalization time of uterine artery embolization group was MD-28.29 d ~ 95 and CI: -31.08- 25.51U P 0.00001, the amount of bleeding was MD-448.47mL9595CIw-513.57C7-383.3ng / P 0.00001, and the blood 尾 -HCG was recovered by 尾 -HCG. In normal time, MD-20.167 d ~ (95) CI: -33.01 ~ -7.32% P0. 002) and the success rate of treatment were higher than those of methotrexate group (R: 1.35 ~ 95 CI: 1.05 ~ 1.73 P0. 02). There was no significant difference in the recovery time of menstruation between the two groups (MD-2.93 d ~ 95 CI: -6.03) 0.16% P0.06, and the incidence of side effects (RR: 0.96 ~ 95CI: 0.51C: 1.82P 0.90). Conclusion uterine artery embolization is effective in the treatment of scar pregnancy after cesarean section.
【作者单位】：深圳市宝安区妇幼保健院产科;
【分类号】：R714.22

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