国际生殖健康/计划生育杂志
國際生殖健康/計劃生育雜誌
국제생식건강/계화생육잡지
JOURNLA OF INTERNATIONAL REPRODUCTIVE HEALTH/FAMILY PLANNING
2014年
3期
243-247
,共5页
廖静%何明凤%杨亚川%胡丽娜
廖靜%何明鳳%楊亞川%鬍麗娜
료정%하명봉%양아천%호려나
子宫%瘢痕%妊娠中期%引产%依沙吖啶%米非司酮%米索前列醇%Meta分析
子宮%瘢痕%妊娠中期%引產%依沙吖啶%米非司酮%米索前列醇%Meta分析
자궁%반흔%임신중기%인산%의사아정%미비사동%미색전렬순%Meta분석
Uterus%Cicatrix%Pregnancy trimester,second%Labor,induced%Ethacridine%Mifepristone%Misoprostol%Meta-analysis
目的：系统评价目前主要采用的2种瘢痕子宫中期妊娠引产方法的疗效。方法：计算机检索MEDLINE、EMBASE、万方数据库、维普中文科技期刊数据库和中国知网（CNKI），检索时限均从建库至2013年11月，纳入关于瘢痕子宫中期妊娠引产且引产方法包括米非司酮联合米索前列醇及米非司酮联合依沙吖啶2种方法的随机对照试验，进行文献筛选及质量评价，采用RevMan5.2软件进行统计分析。结果：共纳入8篇文献，文献质量评价根据Jadad量表评分标准。Meta分析结果表明，米非司酮联合依沙吖啶组（试验组）与米非司酮联合米索前列醇组（对照组）相比，能明显缩短宫缩发动时间；（P＜0.00001，WMD=-12.60，95%CI：-17.17～-8.03；P=0.0005，WMD=-10.50，95%CI：-16.46～-4.55），降低胎盘胎膜残留率（Z=3.07，P=0.002，95%CI：0.37～0.80）、提高引产成功率（Z=2.31，P=0.02，95%CI：0.19～0.88），但2组的总产程（P=0.10，WMD=-2.16，95%CI：-4.73～0.42）及产后24 h内阴道出血量（P=0.11，WMD=-29.01，95%CI：-64.12～6.09）差异均无统计学意义。结论：米非司酮联合依沙吖啶用于瘢痕子宫中期妊娠引产在宫缩发动时间、引产总时间、胎盘胎膜残留率及引产成功率方面均优于米非司酮联合米索前列醇，但前者在引产总产程及产后24 h内阴道出血量方面未显示明显优势。
目的：繫統評價目前主要採用的2種瘢痕子宮中期妊娠引產方法的療效。方法：計算機檢索MEDLINE、EMBASE、萬方數據庫、維普中文科技期刊數據庫和中國知網（CNKI），檢索時限均從建庫至2013年11月，納入關于瘢痕子宮中期妊娠引產且引產方法包括米非司酮聯閤米索前列醇及米非司酮聯閤依沙吖啶2種方法的隨機對照試驗，進行文獻篩選及質量評價，採用RevMan5.2軟件進行統計分析。結果：共納入8篇文獻，文獻質量評價根據Jadad量錶評分標準。Meta分析結果錶明，米非司酮聯閤依沙吖啶組（試驗組）與米非司酮聯閤米索前列醇組（對照組）相比，能明顯縮短宮縮髮動時間；（P＜0.00001，WMD=-12.60，95%CI：-17.17～-8.03；P=0.0005，WMD=-10.50，95%CI：-16.46～-4.55），降低胎盤胎膜殘留率（Z=3.07，P=0.002，95%CI：0.37～0.80）、提高引產成功率（Z=2.31，P=0.02，95%CI：0.19～0.88），但2組的總產程（P=0.10，WMD=-2.16，95%CI：-4.73～0.42）及產後24 h內陰道齣血量（P=0.11，WMD=-29.01，95%CI：-64.12～6.09）差異均無統計學意義。結論：米非司酮聯閤依沙吖啶用于瘢痕子宮中期妊娠引產在宮縮髮動時間、引產總時間、胎盤胎膜殘留率及引產成功率方麵均優于米非司酮聯閤米索前列醇，但前者在引產總產程及產後24 h內陰道齣血量方麵未顯示明顯優勢。
목적：계통평개목전주요채용적2충반흔자궁중기임신인산방법적료효。방법：계산궤검색MEDLINE、EMBASE、만방수거고、유보중문과기기간수거고화중국지망（CNKI），검색시한균종건고지2013년11월，납입관우반흔자궁중기임신인산차인산방법포괄미비사동연합미색전렬순급미비사동연합의사아정2충방법적수궤대조시험，진행문헌사선급질량평개，채용RevMan5.2연건진행통계분석。결과：공납입8편문헌，문헌질량평개근거Jadad량표평분표준。Meta분석결과표명，미비사동연합의사아정조（시험조）여미비사동연합미색전렬순조（대조조）상비，능명현축단궁축발동시간；（P＜0.00001，WMD=-12.60，95%CI：-17.17～-8.03；P=0.0005，WMD=-10.50，95%CI：-16.46～-4.55），강저태반태막잔류솔（Z=3.07，P=0.002，95%CI：0.37～0.80）、제고인산성공솔（Z=2.31，P=0.02，95%CI：0.19～0.88），단2조적총산정（P=0.10，WMD=-2.16，95%CI：-4.73～0.42）급산후24 h내음도출혈량（P=0.11，WMD=-29.01，95%CI：-64.12～6.09）차이균무통계학의의。결론：미비사동연합의사아정용우반흔자궁중기임신인산재궁축발동시간、인산총시간、태반태막잔류솔급인산성공솔방면균우우미비사동연합미색전렬순，단전자재인산총산정급산후24 h내음도출혈량방면미현시명현우세。
Objective:To systematically review the application effect of two main methods in induced labor in midtrimester pregnancy of cicatricial uterus. Two methods were the Mifepristone combined with misoprostol and the mifepristone combined with ethacridine. Methods:We searched MEDLINE,EMBASE,VIP Database,Wanfang Database and CNKI(from inception to Nov. 2013). Randomized controlled trials(RCTs) of induced labor in mid-pregnancy of cicatricial uterus, with methods of the Mifepristone combined with Misoprostol (group A) or the Mifepristone combined with Ethacridine (group B), were reviewed and evaluated. RevMan5.2 software was used for Meta-analysis. Results:Eight literatures were included, and quality of the literatures was based on the Jadad scale scoring criteria. Meta-analysis showed that the group B was significantly superior to the group A in the time of launching uterine contraction (P<0.000 01,WMD=-12.60,95%CI:-17.17, -8.03) and induction (P=0.000 5,WMD=-10.50,95%CI:-16.46,-4.55),placental and fetal membrane residues (Z=3.07,P=0.002,95%CI:0.37,0.80) and induced labor success rate(Z=2.31,P=0.02,95%CI:0.19,0.88),and that there were no significant differences between two groups in the total stage of labor (P=0.10,WMD=-2.16, 95%CI:-4.73,0.42) and the amount of vaginal bleeding within 24 hours after delivery(P=0.11,WMD=-29.01, 95%CI:-64.12,6.09). Conclusions:When the induced labor in midtrimester pregnancy of cicatricial uterus was used, the Mifepristone combined with Ethacridine was significantly superior to the Mifepristone combined with Misoprostol in the time of launching uterine contraction, total time of induced labor,placental and fetal membrane residue, and the success rate of induced labor, except the total stage of labor and amount of vaginal bleeding within 24 hours after delivery.
