胎儿镜下气管球囊阻塞术治疗先天性膈疝效果的系统评价

发布时间：2018-11-05 07:49

【摘要】：目的:系统评价胎儿镜下气管球囊阻塞术(FETO)对先天性膈疝(CDH)的治疗作用。方法:计算机全面检索相关文献数据库关于FETO对CDH胎儿治疗作用的相关文献,检索英文数据库:Embase、Pub Med、Cochrane Central Register of Controlled Trials(CCRT)、Web of Science、ACP、Medline及Ovid;检索中文数据库:中国生物医学文献数据库(CBM)、相关期刊论文(CNKI)、维普(VIP),万方;手工检索相关会议资料、论文集及学位论文汇编等。检索时间为自建库至2016年9月,检索内容为FETO对CDH胎儿治疗作用的随机对照试验(randomized controlled trial,RCT)。采用Cochrane系统评价法,对检索文献进行质量评价和Meta分析,参照PRISMA报告规范进行报告。其异质性采用I~2检验,I~2≤50%采用固定效应模型,I250%采用随机效应模型;采用Mantel-Haenszel法评估RR和95%CI。结果:检索相关文献,共两篇符合本研究纳入标准,纳入受试者孕妇共65例。对纳入研究文献的方法学质量评价结果显示纳入文献质量适中。FETO组和对照组均未发生孕产妇死亡和输血。FETO组与对照组妊娠结局的Meta分析结果示:FETO明显增加早产(RR 1.99,95%CI 1.09~3.61,P=0.02)和未足月胎膜早破(RR 2.41,95%CI 1.26~4.61,P=0.01)的发病风险,而胎盘早剥(RR 3.55,95%CI 0.43~29.42,P=0.24)、母体感染(RR 3.32,95%CI 0.36~30.21,P=0.29)和新生儿存活(RR 2.86,95%CI 0.10~80.82,P=0.54)的发生率两组比较差异无统计学意义。结论:FETO增加早产和未足月胎膜早破的发病风险,不增加胎盘早剥、母体感染、孕产妇死亡的发病风险,其治疗作用有待进一步评估。
[Abstract]:Objective: to evaluate the efficacy of (FETO) in the treatment of congenital diaphragmatic hernia (CDH). Methods: the relevant literatures about the effect of FETO on the fetal treatment of CDH were searched by computer, and the English databases: Embase,Pub Med,Cochrane Central Register of Controlled Trials (CCRT), Web of Science,ACP,Medline and Ovid; were searched. Chinese database: Chinese biomedical literature database (CBM), China periodical full-text database (CNKI), Weipu (VIP), Wanfang; manual retrieval of related conference materials, papers and dissertations, etc. The retrieval time was from the self-built library to September 2016, and the retrieval was a randomized controlled trial (randomized controlled trial,RCT) on the therapeutic effect of FETO on CDH fetus. The Cochrane system evaluation method was used to evaluate the quality and Meta of the retrieval documents, and to report according to the PRISMA report specification. The heterogeneity was tested by Ion2 test, If2 鈮，

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