TCu220C宫内节育器脱落率影响因素的系统评价  

Systematical review on the influence factor of the expulsion rate of TCu220C intrauterine device

作　　者：姚捷[1] 杨月华[1] 李瑛[1] 

机构地区：[1]江苏省计划生育科学技术研究所,南京210036

出　　处：《中国计划生育学杂志》2016年第4期220-224,235,共6页Chinese Journal of Family Planning

基　　金：国家卫计委卫生技术评估项目(20140603)

摘　　要：目的:采用meta分析方法评价不同地区、不同放置时期对TCu220CIUD脱落率的影响,为IUD安全使用提供科学依据。方法:采用计算机检索PubMed、EMBASE、CENTRAL等9个数据库和WHO/FDA/IUD生产企业/临床试验注册相关网站,采用Openmeta analyst和RevMan5.3.3进行数据的分析与合并。结果:共检索到7726篇文献,根据纳入及排除标准,最终纳入31篇文献,均为RCT(随机对照试验)或准RCT。比较TCu220C和其它10种IUD分析结果显示:①不同放置时期的TCu220C脱落率中,人工流产术时放置TCu220C脱落率是月经间期放置的3.8倍(P<0.05)。②在1年随访时TCu220C的脱落率高于爱母型IUD和MCuⅡIUD(P<0.05)。在随访时,TCu220C的脱落率低于金属单环(P<0.05);与活性165、MLCu250、活性γ型、V铜、宫铜300、MLCu375、TCu380A等7种IUD比较均无统计学意义。结论:本研究首次报告了基于RCT的TCu220C的脱落率影响因素定量分析的系统评价结果,国外的研究数据表明人工流产术时放置增加TCu220CIUD脱落的风险;在TCu220C的临床应用中应关注高风险人群,提高TCu220C的避孕效果。Objective：A meta analysis was done to evaluate of different inserting period influence on expulsion rate of TCu220 CIUD,to compare the expulsion rate of TCu220 CIUD with that of other IUD,and to provide evidence for safety using TCu220 CIUD.Methods：PubMed,EMBASE,CENTRAL,and other 9databases were searched.The websites of WHO,FDA and IUD manufacturer related with clinical trial registration were also searched.Openmeta analyst and RevMan5.3.3were used to meta analysis.Results：A total of 7726 articles were retrieved.According to include standards and exclude standards,eventually only 31 randomized controlled trials（RCTs）or Qusi RCTs were included for meta analysis.Meta analysis showed that：（1）Among the different period of TCu220 CIUD inserting,the expulsion rate of insertion immediately after artificial abortion was 3.8times than that of intermenstruum insertion（P〈0.05）.（2）At 1year follow up,the expulsion rate of TCu220 Cwas significantly higher than those of MCu IUD and MCuⅡIUD（P〈0.05）.And at 1year and 2years of follow up,the expulsion rate of TCu220 Cwas lower than that of Stainless SteelRing（P〈0.05）.But no statistical significance were found when TCu220 Ccompared with Active165,MLCu250,Activeγ,Copper V,GT 300,MLCu375,and TCu380 A.Conclusions：Though some studies abroad suggested insertion immediately after artificial abortion maybe increase the risk of expulsion of TCu220 CIUD,this study is the first time to report that insertion immediately after artificial abortion is a high risk factors for expulsion of TCu220 Cby systematical review.In order to promote the safety using TCu220 CIUD,the high risk population of TCu220 CIUD using should be paid more attention to.

关 键 词：TCU220C 宫内节育器 脱落 系统评估 

分 类 号：R169.4[医药卫生—公共卫生与预防医学]