三种宫腔屏障预防中重度宫腔粘连分离术后再粘连疗效的Meta分析  

Meta analysis of the efficacy of three kinds of uterine barriers in preventing re-adhesion after separation of moderate or severe intrauterine adhesion

作　　者：王丽芳[1] 李晓雨 刘玉环[1] 赵艳忠[1] Wang Lifang;Li Xiaoyu;Liu Yuhuan;Zhao Yanzhong(Department of Obstetrics and Gynecology,Fu Xing Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属复兴医院妇产科,北京100038

出　　处：《中国医师进修杂志》2023年第1期57-63,共7页Chinese Journal of Postgraduates of Medicine

摘　　要：目的评估中重度宫腔粘连分离术后采用COOK球囊、Foley球囊和宫内避孕器三种宫腔屏障预防再粘连的效果。方法检索PubMed、Embase、Medline、Cochrane Library、中国知网、万方数据和维普网,收集自建库至2021年12月关于中重度宫腔粘连分离术后采用COOK球囊、Foley球囊和宫内避孕器预防再粘连效果的随机对照试验。采用Revman 5.1软件进行Meta分析。结果根据纳入标准共入选16篇文献。Meta分析结果显示,COOK球囊预防术后再粘连率、月经改善率和术后妊娠率明显优于宫内避孕器(OR = 0.31、2.75和1.58,95%CI 0.19~0.49、1.74~4.35和1.07~2.34,P<0.01);Foley球囊预防术后再粘连率、月经改善率和术后妊娠率明显优于宫内避孕器(OR = 0.39、1.90和1.73,95%CI 0.27~0.57、1.33~2.71和1.02~2.39,P<0.01或<0.05)。结论中重度宫腔粘连分离患者术后采用COOK球囊和Foley球囊预防再粘连效果明显优于宫内避孕器。Objective To evaluate the efficacy of three kinds of uterine barriers:cook balloon,Foley balloon and intrauterine devices in preventing re-adhesion after separation of moderate or severe intrauterine adhesions.Methods Seven databases including PubMed,Embase,Medline,Cochrane Library,China HowNet,Wanfang and CQVIP were used to retrieve,and the randomized controlled trials on the effect of using COOK balloon,Foley balloon and intrauterine devices to prevent re-adhesion after the separation of moderate and severe intrauterine adhesions were collected from the establishment of the database to December 2021.Revman 5.1 software was used for Meta analysis.Results A total of 16 articles were selected according to the inclusion criteria.Meta analysis results showed that the rates of preventing postoperative re-adhesion,improving menstruation and pregnancy in COOK balloon were significantly better than those in intrauterine devices(OR=0.31,2.75 and 1.58;95%CI 0.19 to 0.49,1.74 to 4.35 and 1.07 to 2.34;P<0.01);the rates of preventing postoperative re-adhesion,improving menstruation and pregnancy in Foley balloon were significantly better than those in intrauterine devices(OR=0.39,1.90 and 1.73;95%CI 0.27 to 0.57,1.33 to 2.71 and 1.02 to 2.39;P<0.01 or<0.05).Conclusions The use of COOK balloon and Foley balloon to prevent adhesion is better than the use of intrauterine devices in preventing re-adhesion in patients with moderate or severe intrauterine adhesions.

关 键 词：宫腔粘连 COOK球囊 Foley球囊 宫内避孕器 META分析 

分 类 号：R713.4[医药卫生—妇产科学]