手术治疗卵巢子宫内膜异位囊肿对妊娠结局利弊影响的Meta分析

发布时间：2018-11-18 17:00

【摘要】：目的:探讨手术治疗卵巢子宫内膜异位囊肿(OEM)对妊娠结局利弊的影响。方法:检索2014年12月以前在Pubmed、EMbase、The Cochrane Library、CBM、CNKI、Wan Fang等数据库发表的关于手术治疗OEM对妊娠结局利弊影响的文献。对纳入文献进行质量评价及数据提取,采用STATA11.0软件进行Meta分析。结果:本研究纳入13篇文献,手术组1135例,非手术组856例,两组基线均衡。Meta分析结果提示,对于患有r AFS I~II期OEM且有生育要求的育龄妇女,手术切除OEM能改善妊娠率(RR 1.35,95%CI 1.09~1.68,P=0.006);对于r AFS III~IV期患者,手术切除OEM未改善妊娠率(RR 1.66,95%CI 0.74~3.75,P=0.221)。对于患有直径≥3cm或单侧OEM的患者,手术切除OEM未改善妊娠率(RR 1.27,95%CI 0.80~2.02,P=0.305;RR 1.04,95%CI0.76~1.42,P=0.795)。对于未接受任何ART治疗的OEM患者,手术切除OEM改善妊娠率(RR 3.56,95%CI 1.98~6.43,P0.001)。手术切除OEM未改善活产率(RR 0.81,95%CI 0.45~1.47,P=0.489)。结论:对于患有r AFS I~II期OEM且有生育要求的育龄妇女,手术切除OEM改善妊娠率,术后是否采取ART助孕对妊娠结局无明显影响,推荐确诊OEM后行手术切除OEM。对于患有r AFS III~IV期、直径≥3cm或单侧OEM且具有生育要求的育龄妇女,尚无证据支持手术切除OEM能改善妊娠结局。
[Abstract]:Objective: to investigate the effect of surgical treatment of ovarian endometriosis cyst (OEM) on pregnancy outcome. Methods: to search the literature published in Pubmed,EMbase,The Cochrane Library,CBM,CNKI,Wan Fang and other databases before December 2014 on the effect of surgical treatment of OEM on pregnancy outcome. The quality evaluation and data extraction of the literature were carried out, and the Meta analysis was carried out with STATA11.0 software. Results: this study included 13 articles, 1135 cases in the operative group and 856 cases in the non-operative group. The results of Meta analysis showed that: for women of reproductive age with r AFS I~II stage OEM and fertility requirements, Surgical resection of OEM could improve pregnancy rate (RR 1.35 / 95 CI 1.09 / 1.68 P0. 006). For r AFS III~IV patients, the pregnancy rate was not improved by resection of OEM (RR 1.6695 CI 0.74 3.75 P0. 221). For patients with diameter 鈮，

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