摘要
目的系统评价子宫动脉栓塞在剖宫产术后子宫瘢痕妊娠中的疗效。方法以动脉栓塞(arterial embolization)、子宫瘢痕妊娠(cesarean scar pregnancy,CSP)、随机对照实验(randomized controlled trial,RCT)、剖宫产(cesarean section)、甲氨蝶呤(methotrexate,MTX)等检索词全面检索Cochrane图书馆、Embase、Pub Med,并检索中国生物医学文献数据库(CBM)、中国期刊全文数据库(VIP)、中文科技期刊数据库(CNKI)和万方数据库(Wanfang Data),检索时间截止至2015年5月,并将符合纳入标准的文献按照Cochrane协作网推荐的方法进行系统评价。结果共纳入的6篇文献,4篇比较子宫动脉栓塞术与MTX疗效;2篇比较子宫动脉化疗栓塞术与MTX疗效,其中1篇比较不同栓塞剂(明胶海绵及聚乙烯醇颗粒)化疗栓塞和单纯MTX的疗效。系统评价结果显示子宫动脉(化疗)栓塞组住院时间(MD-28.29 d,95%CI:-31.08^-25.51,P<0.00001)、出血量(MD-448.47 m L,95%CI:-513.57^-383.37,P<0.00001)、血β-HCG恢复正常时间(MD-20.167 d,95%CI:-33.01^-7.32,P=0.002)及治疗成功率(RR:1.35,95%CI:1.05~1.73,P=0.02)均优于甲氨蝶呤组,两组月经恢复时间(MD-2.93 d,95%CI:-6.03~0.16,P=0.06)、副反应发生率(RR:0.96,95%CI:0.51~1.82,P=0.90)无统计学意义。结论子宫动脉栓塞术治疗剖宫产术后瘢痕妊娠疗效确切。
Objective To review the effects of uterine arterial embolization( UAE) in cesarean scars pregnancy by meta-analysis. Methods Searched databases including the Cochrane Library,EMbase,PubM ed, CBMdisc, VIP, CNKI and Wanfang Data to assemble the RCT of cesarean scars pregnancy( CSP). Retrieval time was May 2015. The RevM an 5. 0 software was used for data analysis.Results From the 6 articles enrolled in this study,4 articles compared the UAE with MTX; and the other 2 articles compared uterine artery chemoembolization with MTX, one article comparing different embolic agents( gelatin sponge and polyvinyl alcohol particles) and MTX. The results show that the effectiveness of UAE is superior to MTX in length of hospital stay( MD-28. 29 d,95% CI:-31. 08 ^-25. 51,P < 0. 00001),bleeding( MD-448. 47 mL,95% CI:-513. 57 ^-383. 37, P < 0. 00001), time till resolution of serum β-HCG( MD-20. 167 d,95% CI:-33. 01 ^-7. 32,P = 0. 002) and successful rate( RR: 1. 35,95% CI: 1. 05 ~ 1. 73, P = 0. 02), and there is no significant differences in time tillresolution of menstruation( MD-2. 93 days,95% CI:-6. 03 ~ 0. 16, P = 0. 06) and rate of adverse effects cases( RR: 0. 96,95% CI: 0. 51 ~ 1. 82,P = 0. 90). Conclusions Uterine arterial embolization has exact efficacy in the treatment of cesarean section scar pregnancy.
出处
《妇产与遗传（电子版）》
2016年第4期52-55,共4页
Obstetrics-Gynecology and Genetics (Electronic Edition)
关键词
剖宫产术
子宫瘢痕妊娠
子宫动脉栓塞
META分析
Cesarean section
Cesarean scar pregnancy
Uterine arterial embolization
Meta-analysis
