关于子宫内膜息肉和内膜息肉切除术对不孕症患者妊娠率影响的系统评价

发布时间：2018-04-01 00:36

本文选题：子宫内膜息肉　切入点：不孕症　出处：《重庆医科大学学报》2016年03期

【摘要】：目的:系统评价子宫内膜息肉和内膜息肉切除术对不孕症患者妊娠率的影响,旨在指导不孕症患者常规进行宫腔镜检查,以期及时发现内膜病变并实施手术治疗,从而提高妊娠率。方法:检索the Cochrane Central Register of Controller Trails(CENTRAL)、EMBASE、Pub Med,检索时间自各数据库建库开始截止2015年1月为止。查找有关子宫内膜息肉及内膜息肉切除术对不孕症患者妊娠率影响的观察性研究,通过Revman 5.3软件对筛选的文献数据进行Meta分析,结果通过RR值与相应的95%CI进行比较。结果:共有6篇文献,7组数据纳入。3篇关于有/无子宫内膜息肉对不孕患者妊娠率的影响的研究,共纳入内膜息肉患者454例,其中妊娠的有111例,妊娠率为24.45%(111/454)。无内膜息肉患者共5 595例,其中妊娠的有1 706例,妊娠率为30.49%(1 706/5 595)。结果显示内膜息肉会降低不孕患者妊娠率(RR=1.19,95%CI=1.01~1.40,P=0.030)。各研究间无明显异质性(P=0.410,I2=0%)。4篇关于内膜息肉切除术对不孕患者妊娠率的影响的文献。治疗组共222例,共有114例怀孕,妊娠率51.35%(114/222)。对照组227例,共有60例怀孕,妊娠率26.43%(60/227)。结果显示内膜息肉切除术可提高不孕患者妊娠率(RR=1.61,95%CI=1.01~2.57,P=0.050)。各研究间有中度的异质性(P=0.030,I2=65%)。结论:子宫内膜息肉是导致不孕症的重要因素之一。对于B超及子宫输卵管造影提示宫腔异常的不孕症患者,需常规排除是否存有子宫内膜息肉,一旦发现需尽早诊断,及时手术处理,从而提高妊娠率。
[Abstract]:Objective: to evaluate the effect of endometrial polyp and endometrial polyposectomy on pregnancy rate in infertile women. Methods: to search the Cochrane Central Register of Controller trailsof EMBASE Pub Med.Retrieval time from each database to January 2015. Find out the pregnancy rate of infertility patients after endometrial polyposis and endometrial polyposis resection. An observational study of the effects, The selected literature data were analyzed by Meta with Revman 5.3 software. Results: the RR value was compared with the corresponding 95%CI. Results: a total of 6 articles and 7 groups of data were included in this study on the pregnancy rate of infertile patients with or without endometrial polyps. A total of 454 patients with endometrial polyps were included in the study. Among them, 111 cases were pregnant, and the pregnancy rate was 24.45%. There were 5,595 cases without endometrial polyps, of which 1,706 cases were pregnant. The pregnancy rate was 30.490.706 / 5595%. The results showed that endometrial polyps decreased pregnancy rate in infertile patients. There was no significant difference between the two groups. There was no significant heterogeneity between the two groups on the effect of endometrial polyposis resection on the pregnancy rate of infertile patients. In the treatment group, there were 222 cases of pregnancy. The pregnancy rate was 51.35% 114 / 222%. In the control group, 227 cases were pregnant, 60 cases were pregnant. The pregnancy rate was 26.43 / 227.The results showed that endometrial polyposis resection could increase the pregnancy rate of infertile patients. There was moderate heterogeneity between the two studies. Conclusion: endometrial polyp is one of the important factors leading to infertility. For B ultrasound and oocyte transfusion, endometrial polyp is one of the important factors leading to infertility. Tube angiography indicates that infertility patients with abnormal uterine cavity, It is necessary to rule out the existence of endometrial polyps, and to improve pregnancy rate by early diagnosis and timely surgical treatment.
【作者单位】：重庆医科大学附属第一医院妇科;上海交通大学医学院附属国际和平妇幼保健院;
【基金】：国家自然科学基金资助项目(编号:81471417)
【分类号】：R711.6;R713.4

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