宫颈上皮内瘤变锥切手术治疗对妊娠结局影响的Meta分析  

Influence of cervical conization of CIN on pregnancy outcomes:A Meta-analysis

作　　者：刘雁林[1] 马彩玲[1] 陈建欢[1] 

机构地区：[1]新疆医科大学第一附属医院妇科,新疆乌鲁木齐830054

出　　处：《中国妇幼健康研究》2014年第2期217-222,共6页Chinese Journal of Woman and Child Health Research

基　　金：国家自然科学基金资助项目(编号:8110278);自治区重大疾病医学重点实验室开放课题资助项目(编号:SKLIB-XJMDR-20122013)

摘　　要：目的：探讨宫颈上皮内瘤变患者行宫颈锥形切除术对妊娠结局、分娩结局的影响。方法计算机检索Cochrane Library、PubMed、SCI及万方、CNKI、CBM等数据库并辅以手工检索相关期刊，检索时间至2013年3月。由两名研究者独立筛选文献、提取资料及方法学质量评价，用RevMan 5．1．7软件进行Meta分析。结果共纳入病例-对照试验11篇，包括721例病例组与5565对照组。 Meta分析结果显示：与未行宫颈锥切的正常人群相比，宫颈锥切手术对治疗年轻有生育要求的宫颈上皮内瘤变分娩时宫颈裂伤的发生率无统计学意义（OR＝2．15，95％CI：0．51～9．09，P＝0．30），妊娠率无统计学意义（OR＝1．02，95％CI：0．59～1．76，P＝0．94），分娩方式（剖宫产或阴道分娩）上无统计学意义（OR＝1．04，95％CI：0．86～1．27，P＝0．06），流产的发生率无统计学意义（OR＝1．34，95％CI：0．81～2．23，P＝0．26）。但在早产率（OR＝2．16，95％CI：1．56～2．99，P＜0．00001）、胎膜早破的发生率（OR＝2．82，95％CI：1．70～4．67，P＜0．00001）、新生儿低体重儿的发生率（OR＝2．62，95％CI：1．62～4．24，P＜0．00001）等方面有统计学意义。结论与未行宫颈锥切的正常人群相比，宫颈锥切手术对术后妊娠率、分娩方式、宫颈裂伤以及流产率无影响，但会增加术后早产、胎膜早破及低出生体重儿的发生率。Objective To explore the influence of cervical conization of cervical intraepithelial neoplasia （CIN） on pregnancy outcomes and delivery outcomes.Methods Cochrane Library, PubMed, SCI and Wanfang, CNKI, CBM and other databases were searched , and hand searching of relevant journals was supplemented to search related literatures up to March 2013.Literatures were screened , extracted and assessed independently by two investigators .RevMan 5.1.7 software was used for Meta-analysis.Results Totally 11 case-control studies were recruited , including 721 cases and 5 565 controls.Meta-analysis results showed that there were no significance differences between normal people without undergoing cervical conization and young women with fertility requirement undergoing cervical conization in the incidence of cervical laceration （OR=2.15, 95%CI：0.51-9.09, P=0.30）, pregnancy rate （OR=1.02,95%CI：0.59-1.76, P=0.94）, delivery mode （OR=1.04,95%CI：0.86-1.27,P=0.06）, and incidence of abortion （OR=1.34,95%CI：0.81-2.23, P=0.26）.But the differences in the incidence of preterm birth （OR=2.16,95%CI：1.56-2.99,P〈0.00001）, premature rupture of membranes （OR=2.82,95%CI：1.70-4.67,P〈0.00001）, and low birth weight （OR=2.62,95%CI：1.62-4.24, P〈0.00001） were significant .Conclusion Compared to normal population , cervical conization has no influence on postoperative pregnancy rate , mode of delivery, cervical laceration and abortion rate , but will increase the incidence of preterm birth , premature rupture of membranes and low birth weight on cervical cancer patients .

关 键 词：宫颈上皮内瘤变 宫颈锥切术 妊娠结局 META分析 病例对照研究 

分 类 号：R711[医药卫生—妇产科学] R714[医药卫生—临床医学]