子宫内膜异位症术后复发危险因素的系统评价

发布时间：2018-05-10 11:49

本文选题：子宫内膜异位症 + 复发　；参考：《重庆医科大学》2014年硕士论文

【摘要】：目的：运用循证医学理论，对子宫内膜异位症术后复发的危险因素进行系统评价。方法：检索Pubmed、CENTRAL、EMBASE、VIP、CNKI、万方电子数据库中关于子宫内膜异位症术后复发相关因素研究，按照已设定的排除纳入标准进行文献初筛和全文筛选，对最终纳入的文献进行质量评价。设计数据提取表格，提取纳入文献中相关数据。采用系统评价软件Revman manager5.2进行数据统计分析，计算各因素合并统计量的均数差、相对危险度及其95%可信区间。结果：经过筛选，共纳入相关文献15篇，采用纽卡索-渥太华量表（Newcastle-Ottawa Scale，NOS）进行文献的质量评价，所纳入的文献NOS评分为6-8分。Meta分析结果显示，术前使用子宫内膜异位症相关药物暴露组与非暴露组术后复发风险无显著差异（RR=1.16,95%CI[0.95,1.43], P=0.15）；r-AFS分期高暴露组与非暴露组术后复发风险有显著差异（RR=2.04,95%CI[1.65,2.52], P＜0.05）；既往有子宫内膜异位症相关手术史暴露组与非暴露组术后复发风险有显著差异（RR=9.14,95%CI[2.44,34.25], P＜0.05）；术后妊娠暴露组与非暴露组术后复发率有显著差异（RR=0.50,95%CI[0.33,0.76], P＜0.05）；复发组与非复发组在发病年龄上有显著差异（MD=-1.33，95%CI[-1.97，-0.69]，，P＜0.05）；复发组与非复发组在初潮年龄有显著差异（MD=-0.23，95%CI[-0.42，-0.03]，P＜0.05）。结论：根据现有的纳入资料，Meta分析结果显示，r-ASF分期高、既往有内异症手术史、发病年龄小及初潮年龄早均是术后复发的危险因素；术后妊娠是术后复发的保护性因素；术前使用内异症相关药物增加术后复发倾向。因每项指标中纳入的样本数量限制，上述结论需更多高质量的临床研究加入，增加论证强度。
[Abstract]:Objective: to evaluate the risk factors of postoperative recurrence of endometriosis by using the theory of evidence-based medicine. Methods: the relevant factors related to postoperative recurrence of endometriosis were studied in Wanfang Electronic Database by retrieving Pubmedmedus CENTRALLAL EMBASE and VIPKI. The literature was screened and screened according to the established exclusion criteria, and the quality of the final included literature was evaluated. Design the data extraction form and extract the relevant data into the literature. The system evaluation software Revman manager5.2 was used to analyze the data. The mean difference, relative risk and 95% confidence interval of the combined statistics were calculated. Results: a total of 15 articles were selected and evaluated by Newcastle-Ottawa scale. The NOS score of the literature included was 6-8. Meta-analysis showed that, There was no significant difference in the risk of postoperative recurrence between the drug exposure group and the non-exposed group. There was significant difference in the risk of postoperative recurrence between the high exposure group and the non-exposed group (P < 0.05), and there was no significant difference in the risk of postoperative recurrence between the high exposure group and the non-exposed group (P < 0.05), and there was no significant difference in the risk of recurrence between the high exposure group and the non-exposed group (P < 0.05). There was significant difference in the risk of postoperative recurrence between the exposed group and the non-exposed group (P < 0.05), the recurrence rate of the pregnancy exposure group and the non-exposed group was significantly different (P < 0.05), P < 0.055.There was a significant difference between the relapsing group and the non-recurrence group in the age of onset (P < 0.05), and the difference between the recurrent group and the non-exposed group was significant (P < 0.05). The risk of recurrence was significantly higher in the recurrent group than that in the non-exposed group (P < 0.05); and there was a significant difference between the recurrent group and the non-exposed group in the age of the onset of the disease (P < 0.05), and there was a significant difference in the postoperative recurrence rate between the exposed group and the non-exposed group (P < 0.05). There was significant difference in menarche age between recurrent group and non-recurrence group (P < 0.05). Conclusion: according to the existing data, the results of meta-analysis showed that the risk factors of postoperative recurrence were high stage of r-ASF, history of endodontic surgery, young age of onset and early menarche, postoperative pregnancy was the protective factor of postoperative recurrence. Preoperative use of endodysm-related drugs increased the risk of recurrence after operation. Because of the limited number of samples included in each index, the above conclusions need more high quality clinical research to increase the intensity of demonstration.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.71

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