甲氨蝶呤不同给药途径治疗子宫切口瘢痕妊娠临床研究的meta分析

发布时间：2018-06-24 17:52

本文选题：子宫切口瘢痕妊娠 + 甲氨蝶呤　；参考：《广西医科大学》2014年硕士论文

【摘要】：目的：应用RevMan5.1和STATA12.0软件进行Meta分析，比较甲氨蝶呤(methotrexate，MTX)经B超引导下妊娠组织局部注射和肌肉注射两种不同给药途径治疗子宫切口瘢痕妊娠(cesarean scarpregnancy)的有效性和安全性。方法：按照Cochrane协作网工作手册的要求制定检索策略，检索的数据库有PubMed、EMBASE、OVID、Cochrane、ScienceDirect、EBSCO、CNKI、CBM、VIP、万方数据资源系统等数据库，并辅以手工及其他检索。搜集1978年至2013年12月的相关研究，纳入评价MTX不同给药途径治疗CSP疗效的随机对照临床研究，采用RevMan软件进行Meta分析，比较MTX不同给药途径治疗CSP的有效性和安全性。结果：初检出文献1611篇，仅有12篇随机对照试验符合纳入标准，共计421名患者。Meta分析结果显示：B超引导下妊娠组织局部注射MTX组与肌肉注射MTX组相比，治疗成功率、血人绒毛膜促性腺激素（Human chorionic gonadotropin，HCG）下降到正常的时间、包块消失的时间及轻度不良反应，，差异均有具有统计学意义(P＜0.05)，两组间严重合并症差异无统计学意义（P＞0.05）。结论： MTX治疗CSP采用B超引导下妊娠组织局部注射的给药方法疗效优于肌肉注射给药方法，具有血HCG降到正常的时间短，包块消失较快、轻度不良反应少等优点，对于子宫切除等严重合并症，由于现有的资料尚不足以下结论。就现有研究而言，B超引导下局部注射MTX治疗CSP的方法是安全、有效的。
[Abstract]:Objective: to evaluate the efficacy and safety of methotrexate MTX (methotrexate MTX) in the treatment of uterine incision scar pregnancy (cesarean scarpregnancy) by using Revman 5.1 and STATA12.0 software, and to compare the efficacy and safety of methotrexate MTX in the treatment of uterine incision scar pregnancy with local injection and intramuscular injection under the guidance of B-ultrasound. Methods: according to the work manual of Cochrane Cooperative Network, the search strategy was formulated. The database included PubMeden EMBASEN OVIDE CochraneScience Director EBSCICBMVIPand Wanfang data Resource system and so on, and was supplemented by manual and other retrieval. A randomized controlled clinical study was conducted to evaluate the efficacy of MTX in CSP from 1978 to December 2013. The efficacy and safety of MTX in CSP were analyzed with Revman software. Results: 1611 papers were first detected, only 12 randomized controlled trials met the inclusion criteria. A total of 421 patients. Meta-analysis results showed that the success rate of local MTX injection in pregnancy tissue guided by B-ultrasound was higher than that in intramuscular MTX group. Human chorionic gonadotropin (HCG) decreased to normal time, the time of mass disappearance and mild adverse reactions were significantly different (P < 0. 05), but there was no significant difference between the two groups in severe complications (P > 0. 05). Conclusion: MTX is more effective than intramuscular injection in the treatment of CSP with local injection of CSP under the guidance of B-ultrasound. It has the advantages of short time of blood HCG decreasing to normal, rapid disappearance of mass, and less mild adverse reactions. For severe complications such as hysterectomy, the available data are not sufficient to draw conclusions. As far as current studies are concerned, local injection of MTX under B-ultrasound guidance is safe and effective in the treatment of CSP.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.2

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