医药前沿
醫藥前沿
의약전연
YIAYAO QIANYAN
2015年
21期
209-211,212
,共4页
宫腔镜手术%子宫瘢痕妊娠%随机对照试验%Meta分析
宮腔鏡手術%子宮瘢痕妊娠%隨機對照試驗%Meta分析
궁강경수술%자궁반흔임신%수궤대조시험%Meta분석
Hysteroscopic surgery%Randomized controlled trial%Cesarean scar pregnancy%Meta-analysis
目的:评价宫腔镜手术与传统清宫术治疗子宫瘢痕处妊娠的有效性和安全性。方法:按照循证医学的要求全面计算机检索Cochrane图书馆、Medline、PubMed、EMBASE、万方医学数据库、维普数据库、知网CNKI和中国生物医学数据库CBM,检索时限为1978年1月1日至2015年2月28日,同时进行文献追溯,根据摘要查找相关文献并获取全文,收集宫腔镜手术与传统清宫术治疗子宫瘢痕处妊娠的随机对照试验。结果:检索到符合纳入标准的随机对照试验文献6篇,病例总数424例,Meta分析结果显示:宫腔镜手术治疗的术中出血量[95%C I:-3.50(-4.57,-2.42),P<0.00001]和血清β-H C G降至正常所需时间[95%C I:-2.31(-3.69,-0.93), P﹦0.001]和住院时间[95%C I:-1.99(-3.12,-0.86),P﹦0.0005]均显著少于传统清宫术治疗组。结论:宫腔镜手术较传统清宫术治疗子宫瘢痕处妊娠中有效性与安全性更高,术中出血量少,血清β-HCG降至正常所需时间及住院时间短,可作为临床优先选择的治疗方法。
目的:評價宮腔鏡手術與傳統清宮術治療子宮瘢痕處妊娠的有效性和安全性。方法:按照循證醫學的要求全麵計算機檢索Cochrane圖書館、Medline、PubMed、EMBASE、萬方醫學數據庫、維普數據庫、知網CNKI和中國生物醫學數據庫CBM,檢索時限為1978年1月1日至2015年2月28日,同時進行文獻追溯,根據摘要查找相關文獻併穫取全文,收集宮腔鏡手術與傳統清宮術治療子宮瘢痕處妊娠的隨機對照試驗。結果:檢索到符閤納入標準的隨機對照試驗文獻6篇,病例總數424例,Meta分析結果顯示:宮腔鏡手術治療的術中齣血量[95%C I:-3.50(-4.57,-2.42),P<0.00001]和血清β-H C G降至正常所需時間[95%C I:-2.31(-3.69,-0.93), P﹦0.001]和住院時間[95%C I:-1.99(-3.12,-0.86),P﹦0.0005]均顯著少于傳統清宮術治療組。結論:宮腔鏡手術較傳統清宮術治療子宮瘢痕處妊娠中有效性與安全性更高,術中齣血量少,血清β-HCG降至正常所需時間及住院時間短,可作為臨床優先選擇的治療方法。
목적:평개궁강경수술여전통청궁술치료자궁반흔처임신적유효성화안전성。방법:안조순증의학적요구전면계산궤검색Cochrane도서관、Medline、PubMed、EMBASE、만방의학수거고、유보수거고、지망CNKI화중국생물의학수거고CBM,검색시한위1978년1월1일지2015년2월28일,동시진행문헌추소,근거적요사조상관문헌병획취전문,수집궁강경수술여전통청궁술치료자궁반흔처임신적수궤대조시험。결과:검색도부합납입표준적수궤대조시험문헌6편,병례총수424례,Meta분석결과현시:궁강경수술치료적술중출혈량[95%C I:-3.50(-4.57,-2.42),P<0.00001]화혈청β-H C G강지정상소수시간[95%C I:-2.31(-3.69,-0.93), P﹦0.001]화주원시간[95%C I:-1.99(-3.12,-0.86),P﹦0.0005]균현저소우전통청궁술치료조。결론:궁강경수술교전통청궁술치료자궁반흔처임신중유효성여안전성경고,술중출혈량소,혈청β-HCG강지정상소수시간급주원시간단,가작위림상우선선택적치료방법。
Objective The objective of this study was to evaluate the efficacy and safety of the therapy of cesarean scar pregnancy (CSP) by hysteroscopic surgery with contrast to that by curettage.Methods According to the requirements of Evidence-based medicine, thoroughly searched in Cochrane Library, Medline, PubMed, EMBASE, WANFANG medicine database, CNKI and China Biology Medicine database(CBM) in the period of Jan 1st of 1978 to Feb 28 of 2015, also searched in relevant documents by reviewing the above abstracts, for randomized controlled trials(RCTs) of hysteroscopy surgery and traditional curettage treatment of CSP.Results 6 studies involving 424 patients were included. Meta-analysis showed that the bleeding volumes[95%CI:-3.50(-4.57,-2.42),P<0.00001], recovery time of serumβ-HCG content to normality[95%CI:-2.31(-3.69,-0.93),P=0.001] and hospitalization time[95%CI:-1.99(-3.12,-0.86),P=0.0005] were significantly less in hysteroscopy surgery group compared with curettage treatment group.Conclusion Compared with curettage for CSP, hysteroscopic surgery for CSP appeared to have higher efficacy and safety, with less bleeding volumes, serum β-HCG content recovery time and hospitalization time, and it could be used as prior choice in clinical treatment.