第一代与第二代子宫内膜射频消融技术治疗围绝经期功血临床疗效比较的系统评价

发布时间：2018-04-30 15:07

本文选题：围绝经期妇女 + 功能失调性子宫出血(功血)　；参考：《新疆医科大学》2014年硕士论文

【摘要】：目的：评价第一代与第二代子宫内膜射频消融技术治疗围绝经期功血的临床疗效。方法：检索Cochrane Library、MEDLINE、EMBASE, ISI Web、CBM、中国生物医学文献数据库、万方医学数据库、CNKI等。纳入第一代与第二代子宫内膜射频消融技术治疗围绝经期功血的随机对照试验,对其方法及质量进行系统评价。用RevMan5.0软件进行统计分析。结果：①共纳入7篇符合要求的RCT文献,共计1218例患者。②根据随机方法、分配隐藏、盲法、失访、基线比较和等级描述等对所纳入的研究行质量评估,结果质量7篇文献为高质量文献。Meta分析结果：治疗后12个月月经失血图(PBAC)减小百分比进行了异质性检验结果示P=0.710.05, I2=0%,RR=-9.05,95%CI=[-24.92,6.82],分析可知,差异无统计学意义。治疗后12个月闭经率进行了异质性检验结果示：OR=0.49,95%CI=[0.10,2.41],P=0.380.05,差异无统计学意义。即治疗12个月后,第一代、第二代子宫内膜射频消融技术组患者闭经率无明显差异。对手术时间进行了异质性检验结果示RR=-14.78,95%CI=[-18.67,-10.88], P0.00001,故差异有统计学意义。即第一代、第二代子宫内膜射频消融技术手术所需时间有差异,第二代子宫内膜射频消融技术手术时间比第一代短。对治疗后12个月患者满意度进行了异质性检验结果示OR=4.37,95%CI=[0.24,81.14], P=0.320.05,故差异无统计学意义,即第一代、第二代子宫内膜射频消融技术治疗后12个月患者满意度无差异。结论：第一代与第二代子宫内膜射频消融技术都对围绝经期功血的治疗安全有效,第二代子宫内膜射频消融技术手术时间短,利于在局部麻醉下完成,而且此远期疗效较第一代更好,是一种较好的保守性治疗手段。
[Abstract]:Objective: to evaluate the clinical effect of the first and second generation of endometrial radiofrequency ablation in the treatment of peri-menopausal dysfunctional blood. Methods: Cochrane Library MEDLINE EMBASE, ISI WebCVM, Chinese Biomedical Literature Database and Wanfang Medical Database were searched. A randomized controlled trial of radiofrequency ablation of the first and second generation endometrium for the treatment of peri-menopausal dysfunctional blood was carried out, and the methods and quality were systematically evaluated. Statistical analysis was carried out with RevMan5.0 software. Results 1218 patients were included in 7 RCT articles. A total of 1218 patients were assessed according to random methods, allocation of concealment, blind method, lost interview, baseline comparison and grade description. Results the results of 7 articles of high quality. Meta-analysis showed that the percentage of decrease of PBAC) in menstrual bleeding map was 0.710.05 in 12 months after treatment, and RR-9.05C95CI = [-24.92m6.82]. The results showed that there was no significant difference between the two groups. 12 months after treatment, the rate of amenorrhea was examined by heterogeneity test. The results showed that the ratio of 0. 49% to 95% CI = [0. 10 ~ 2. 41] was 0.380. 05, and there was no significant difference between the two groups. After 12 months of treatment, there was no significant difference in amenorrhea rate between the first generation and the second generation radiofrequency ablation group. The results of heterogeneity test of operation time showed that RRX-14.788% CI = [-18.67 7 -10.88], P 0.00001, so the difference was statistically significant. That is, the first generation, the second generation of endometrium radiofrequency ablation technique need different time, the second generation endometrial radiofrequency ablation technique is shorter than the first generation. The results of heterogeneity test on patients' satisfaction at 12 months after treatment showed that ORX 4.37% 95 CI = [0.24 卤81.14], PX 0.320.05, so there was no significant difference between the first generation and the second generation of endometrial radiofrequency ablation technique 12 months after treatment. Conclusion: both the first generation and the second generation of endometrial radiofrequency ablation are safe and effective in the treatment of peri-menopausal dysfunctional blood. The second generation of endometrial radiofrequency ablation has a short operation time and is beneficial to the completion of local anesthesia. And this long-term effect is better than the first generation, is a better conservative treatment.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.52

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