剖宫产瘢痕妊娠保守治疗的相关危险因素Meta分析

发布时间：2018-06-18 09:58

  本文选题：瘢痕妊娠 + 保守治疗　； 参考：《实用妇产科杂志》2015年01期

【摘要】：目的:对剖宫产瘢痕妊娠(CSP)保守治疗的相关危险因素进行系统评价。方法:计算机检索Pubmed、Embase、Google、中国知网、维普、万方数据库,并辅以手工检索,检索时限2000~2013年,纳入研究的CSP为保守治疗失败的患者,其相关危险因素包括超声检查分型、胎血管搏动、治疗前血β-HCG值、年龄、孕周。采用Rev Man 5.0软件对纳入文献的数据进行Meta分析,计算相关危险因素的比值比(OR)及95%可信区间(CI)。结果:共筛选出相关文献8篇,中文文献2篇,英文文献6篇。保守治疗患者254例,失败82例,全部入选患者保守治疗失败率32.28%。Meta分析结果显示:包块型CSP(Z=3.46,OR=0.19,95%CI 0.07~0.48,P=0.0005)为保守治疗失败的危险因素,而高龄孕产妇、治疗前可探及胎血管搏动、血β-HCG值20000 U/L及孕周≥8周为CSP保守治疗失败的不确定因素(P0.05)。结论:包块型CSP显著增加治疗过程中严重并发症的发生而导致保守治疗失败,建议对CSP患者治疗前行超声检测评估分型,以避免严重并发症的发生。
[Abstract]:Objective: to evaluate the risk factors associated with conservative treatment of CSP in cesarean scar pregnancy. Methods: Pubmedmedan Embase Google, China knowledge Network, Weip, Wanfang database were searched by computer, supplemented by manual retrieval, the search time was from 2000 to 2013. CSP was included in the study as the patients who failed conservative treatment. The related risk factors included ultrasonic examination and fetal vascular pulsatility. Serum 尾-HCG, age, gestational week before treatment. Rev Man 5.0 software was used to carry out meta-analysis of the data included in the literature, and the ratio of related risk factors was calculated by OR) and 95% confidence interval (CI) was calculated. Results: a total of 8 articles were selected, 2 articles in Chinese and 6 articles in English. The failure rate of conservative treatment was 32.28.Meta-analysis showed that the risk factor of conservative treatment failure was CI 0.07 ~ 0.48%, CI 0.07 ~ 0.48% P0. 0005), while in old pregnant women, fetal vessel pulsatility could be detected before treatment, and the risk factors of failure of conservative treatment were 3.46% (CI 0.07 0. 48% P0. 005), and the risk factors of failure of conservative treatment were 32. 28% and 32. 28%, and the results of meta-analysis showed that: 1. The serum 尾 -HCG value of 20000 U / L and gestational age 鈮，

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