系统评价阴道及舌下使用米索前列醇用于早期妊娠人工流产手术扩张宫颈的有效性和安全性  

Effectiveness and Safety of Vaginal and Sublinguinal Misoprostol for Cervical Ripening before Artificial Abortion of First-Trimester Pregnancy:A Systematic Review

作　　者：干昌平[1] 邹燕[2] 傅璟[3] 李幼平[4] 陶开宇[3] 夏瑞[3] 童琳[3] 江琪琪[3] 原杰彦[3] 卓素艳 

机构地区：[1]四川大学华西医院,成都610041 [2]国家人口计生委科学技术研究所,北京100081 [3]四川大学华西临床医学院,成都610041 [4]中国循证医学中心,成都610041

出　　处：《循证医学》2007年第4期230-234,共5页The Journal of Evidence-Based Medicine

摘　　要：目的系统评价阴道及舌下使用米索前列醇与安慰剂比较用于孕早期人工流产手术扩张宫颈的有效性和安全性。方法检索相关文献并进行Meta分析。据异质性检验(α=0.05)结果采用固定效应模型、敏感性分析或随机效应模型等处理,结果以比值比(OR)或加权均数差(WMD)及其95%可信区间表示。结果纳入文献5篇共482例,均为随机对照试验。其中经阴道给药4篇,舌下给药1篇。人工流产术前经阴道和舌下使用米索前列醇与安慰剂比较宫颈扩张度好的比例均较高。经阴道使用可缩短手术时间,但在其他有效性指标上无明显差异;舌下使用可减少术中出血量。胃肠道副作用发生率在两种给药途径中均无显著差异。结论米索前列醇经阴道或舌下给药在扩张宫颈方面均有较好的临床效果,经阴道使用尚可缩短手术时间。在其他有效性指标和安全性方面,尚有待更多证据加以评价。Objective To evaluate the effectiveness and safety of vaginal and sublinguinal Misoprostol versus placebo for cervical ripening of artificial abortion of first-trimester pregnancy. Methods Related original studies were searched and meta-analysis was conducted later. After heterogeneity test, data were pooled using fixed effect model, sensitivity analysis or randomized effect model, etc. Results were expressed by odds ratio （OR） or weighted mean differences （WMD）, 95%CI was necessary. Results Five original trials （n=482） were found, all RCTs. Four trials using vaginal Misoprostol and one performed sublinguinally. Using Misoprostol vaginally and sublinguinally all had a higher rate of satisfied cervical ripening when compared with placebo. Vaginal Misoprostol could shorten the duration of operation, but had no significant differences when compared with placebo in other outcomes of effectiveness; sublinguinal Misoprostol could reduce the blood loss in the operation. No significant differences were observed in theincidence of gastrointestinal adverse reaction between two groups in neither of the way of taking drugs. Conclusions Using vaginally and sublinguinally,Misoprostol all had a satisfied clinical effect ripening cervix, vaginal Misoprostol could shorten the duration of operation. The evaluation of other outcomes of effectiveness and the safety of Misoprostol versus placebo for cervical ripening needed more proofs.

关 键 词：米索前列醇 人工流产 早期妊娠 有效性 安全性 系统评价 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]