子宫内膜异位症单纯腹腔镜治疗与术后应用GnRHa疗效的Meta分析  

Meta-analysis on Therapeutic Effect Between Single Laparoscopic Surgery and Postoperative Therapy by GnRHa in Endometriosis

作　　者：徐翊[1] 洛若愚[1] 张清[1] 李华[1] 易跃雄[1] 李金芯[1] 

机构地区：[1]武汉大学人民医院妇产科,430060

出　　处：《国际妇产科学杂志》2011年第6期570-574,共5页Journal of International Obstetrics and Gynecology

摘　　要：目的:评价单纯腹腔镜手术治疗与腹腔镜手术后应用促性腺激素释放激素激动剂(GnRHa)治疗子宫内膜异位症的疗效。方法:依据循证医学原则,用Cochrane系统评价方法,检索2000—2011年期间Cochrane图书馆,PUBMED,CNKI,CBM,万方和重庆维普数据库等。纳入单纯腹腔镜手术治疗与腹腔镜手术后联合应用GnRHa治疗子宫内膜异位症的随机对照试验(RCT),采用RevMan5.0软件行Meta分析。结果:①共纳入8篇符合要求的RCT文献,共计862例患者。②所纳入的研究根据随机方法、分配隐藏、盲法、失访、基线比较和等级描述等对所纳入的研究行质量评估,结果质量均达B级。Meta分析结果:术后应用GnRHa组随访1年症状缓解率比单纯腹腔镜组高(OR=4.30,95%CI:2.86～6.47,P<0.01);术后联合应用GnRHa组复发率比单纯腹腔镜组低(OR=0.18,95%CI:0.13～0.26,P<0.01);术后联合应用GnRHa组妊娠率比单纯腹腔镜组高(OR=4.98,95%CI:3.43～7.23,P<0.01)。结论:腹腔镜手术后应用GnRHa治疗子宫内膜异位症的总体疗效优于单纯腹腔镜手术治疗。Objective：To evaluate the efficacy of laparoscopic surgery combined gonadotropin-releasing hormone agonist（GnRHa） with laparoscopic surgery alone in the treatment of endometriosis.Methods：Based on the principles of evidence-based medicine,use Cochrane systematic review method to retrieve randomized controlled trials（RCT） published on Cochrane Library,PUBMED,CNKI,CBM,Wanfang,Chongqing VIP database between 2000 and 2011,which were mainly about laparoscopic surgery combined GnRHa therapy and laparoscopic surgery alone therapy in the treatment of endometriosis.Then use RevMan 5.0 software to do Meta analysis.Results：8 RCT were included,862 patients in total.All of the trials reached grade B based on the quality evaluation methods of allocation concealment,blinding,loss to follow-up,baseline level comparison and grading description.According to meta analysis,Symptom release rate and pregnancy rate in laparoscopic surgery combined GnRHa group were both much higher than laparoscopic surgery alone group（OR=4.30,95%CI为2.86～6.47,P〈0.01） .And the recurrence rate was much lower in laparoscopic surgery combined GnRHa group too（OR=0.18,95%CI：0.13～0.26,P〈0.01） .Conclusions：The efficacy of laparoscopic surgery combined GnRHa therapy is much better than laparoscopic surgery alone in the treatment of endometriosis.

关 键 词：子宫内膜异位症 促性腺素释放激素 腹腔镜检查 META分析 

分 类 号：R713[医药卫生—妇产科学]