宫腔镜子宫内膜息肉切除术后预防复发的Meta分析  

Prevention of Recurrence after Hysteroscopic Endometrial Polypectomy:A Meta-analysis

作　　者：邵超[1] 梁婧[1] 龚文婧[1] SHAO Chao;LIANG Jing;GONG Wenjing(Department of Gynecology,Guang′anmen Hospital Southern District,Chinese Academy of Traditional Chinese Medicine,Beijing 102600,China)

机构地区：[1]中国中医科学院广安门医院南区妇科,北京102600

出　　处：《医学综述》2020年第12期2464-2469,共6页Medical Recapitulate

摘　　要：目的系统分析宫腔镜子宫内膜息肉切除术后应用口服药物或左炔诺孕酮宫内缓释系统(LNG-IUS)预防子宫内膜息肉复发的效果。方法计算机检索中文期刊全文数据库(CNKI)、中文科技期刊数据库(VIP)、万方数据库、Pub Med、CBM、Embase、Cochrance数据库中宫腔镜子宫内膜息肉切除术后预防子宫内膜息肉复发的随机对照试验,检索时间自建库至2018年12月,对文献进行二次筛选并进行Jadad评分,采用Rev Man 5. 3软件进行Meta分析。结果宫腔镜子宫内膜息肉切除术后应用口服药物预防子宫内膜息肉复发最终纳入14项随机对照试验,共1 743例患者,结果显示,试验组复发率低于对照组(OR=0. 18,95%CI 0. 13~0. 25,P <0. 000 01)。应用LNG-IUS预防复发最终纳入10项随机对照组研究,共1 165例患者,结果显示,试验组复发率低于对照组(OR=0. 15,95%CI0. 09~0. 23,P <0. 000 01)。对口服药物组和LNG-IUS组进行发表偏倚分析,倒漏斗图显示并不完全对称,提示可能存在发表偏倚。结论宫腔镜子宫内膜息肉切除术后应用口服药物或LNG-IUS预防子宫内膜息肉复发具有一定的效果。Objective To analyze the effect of oral medication or levonorgestrel-releasing intrauterine system(LNG-IUS)on endometrial polyps recurrence prevention after hysteroscopic endometrial polypectomy.Methods The databases such as:SCI,Embase,CNKI,VIP,Wanfang,PubMed,CBM,Embase and Cochrance were searched to collect randomized controlled trials of prevention of recurrence of endometrial polyps after hysteroscopic endometrial polypectomy from the date of their establishment to Dec.2018.The articles were screened again and graded by Jadad quality scale,and RevMan 5.3 was used for the Meta-analysis.Results 14 randomized controlled trials,involving 1743 patients,of oral medications to prevent endometrial polyp recurrence after hysteroscopic endometrial polypectomy,were included.The results showed that the recurrence rate in the test group was lower than that in the control group(OR=0.18,95%CI 0.13-0.25,P<0.00001).10 randomized controlled trials with a total of 1165 patients using of LNG-IUS to prevent relapse were finally included.The results showed that the recurrence rate in the test group was lower than that in the control group(OR=0.15,95%CI 0.09-0.23,P<0.00001).Analysis of publication bias in the oral medication group and LNG-IUS group indicated that the inverted funnel plots were not completely symmetrical,suggesting possible publication bias.Conclusion Oral medication or LNG-IUS after hysteroscopic endometrial polypectomy has a certain effect for prevention of endometrial polyp recurrence.

关 键 词：子宫内膜息肉 宫腔镜 复发 随机对照试验 META分析 

分 类 号：R711.74[医药卫生—妇产科学]