子宫动脉栓塞术治疗子宫肌瘤的Meta分析

发布时间：2019-01-29 19:58

【摘要】：目的 :比较子宫动脉栓塞术(uterine artery embolization,UAE)与传统外科手术治疗子宫肌瘤的疗效。方法 :计算机检索Pub Med、EMbase、Web of Science、Cochrane Library、相关期刊论文、中国生物医学文献数据库和万方数据中有关UAE与外科手术治疗子宫肌瘤的随机对照试验(randomized controlled trial,RCT),检索时间截至2014年12月。由2名研究者按照纳入标准独立筛选文献,提取资料并交叉核对,并对纳入文献的质量进行评价。采用Rev Man 5.1软件进行Meta分析。结果:共纳入18项研究,包括1 914例患者。Meta分析结果显示,UAE的手术操作时间[均差(mean difference,MD)=-32.10,95%可信区间(confidence interval,CI):-54.51~-9.70;P=0.005)、术后住院时间(MD=-1.89,95%CI:-3.06~-0.73,P=0.001)和恢复日常活动所需时间[MD=-15.74(95%CI:-20.31~-11.18),P0.000 01]均优于外科手术;但UAE的手术技术失败率[相对危险度(relative risk,RR)=2.03(95%CI:1.10~3.77),P=0.02]和再次干预率[RR=5.19(95%CI:3.15~8.55),P0.000 01]均高于外科手术。两组对术后卵泡刺激素(follicle-stimulating hormone,FSH)水平的影响无明显差异[MD=-0.62(95%CI:-1.96~0.71),P=0.36]。结论 :UAE的手术操作时间、术后住院时间和恢复日常活动所需时间均短于外科手术,但手术技术失败率和再次干预率偏高,两组对卵巢功能的影响无明显差异。
[Abstract]:Objective: to compare the curative effect of uterine artery embolization (uterine artery embolization,UAE) with traditional surgery in the treatment of uterine leiomyoma. Methods: the full text database of Pub Med,EMbase,Web of Science,Cochrane Library, Chinese Journal, the Chinese Biomedical Literature Database and Wanfang data were searched by computer. The UAE and surgical treatment of uterine leiomyoma were studied in a randomized controlled trial (randomized controlled trial,RCT). Retrieval time as of December 2014. According to the inclusion criteria, two researchers independently sifted the literature, extracted the data and cross-checked, and evaluated the quality of the included literature. Meta analysis was carried out with Rev Man 5.1 software. Results: a total of 18 studies, including 1 914 patients, were included. The results of Meta analysis showed that the operating time of UAE [mean difference (mean difference,MD) = -32.10 ~ 95% confidence interval (confidence interval,CI): -54.51 ~ 9.70]; P0. 005), postoperative hospitalization time (MD=-1.89,95%CI:-3.06~-0.73,P=0.001) and time to resume daily activities [MD=-15.74 (95%CI:-20.31~-11.18), P 0.00001] was superior to surgery. But the failure rate of surgical techniques in UAE [relative risk (relative risk,RR) = 2.03 (95%CI:1.10~3.77), P0. 02] and re-intervention rate [RR=5.19 (95%CI:3.15~8.55), P0. 00001] were higher than those in surgical procedures. There was no significant difference in the level of follicle stimulating hormone (follicle-stimulating hormone,FSH) between the two groups [MD=-0.62 (95%CI:-1.96~0.71), P0. 36]. Conclusion: the operative time, postoperative hospitalization time and recovery time of UAE were shorter than those of surgery, but the failure rate of surgical technique and the rate of re-intervention were higher. There was no significant difference between the two groups on ovarian function.
【作者单位】：兰州大学公共卫生学院儿少卫生与妇幼保健所;甘肃省妇幼保健院;兰州大学循证医学中心;兰州大学公共卫生学院营养与食品卫生学研究所;
【分类号】：R737.33

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