摘要
目的系统评价地屈孕酮联合戊酸雌二醇预防人工流产术后宫腔粘连(IUA)及改善预后的有效性。方法检索中国知网、万方数据、维普网、中国生物医学文献数据库、PubMed、Embase和the Cochrane Library,收集常规治疗联用地屈孕酮、戊酸雌二醇(试验组)对比常规治疗(对照组)预防人工流产术后IUA的随机对照试验(RCT),检索时限为建库至2024年12月。筛选文献、提取资料、评价文献质量后,采用RevMan 5.4软件进行Meta分析。结果共纳入12篇文献,共计1109例患者。Meta分析结果显示,试验组患者的术后IUA发生率[RR=0.30,95%CI(0.22,0.41),P<0.00001]、术后阴道流血时间[MD=-1.69,95%CI(-2.05,-1.32),P<0.00001]、术后阴道流血量[MD=-10.78,95%CI(-12.19,-9.37),P<0.00001]、术后月经复潮时间[MD=-6.99,95%CI(-8.27,-5.71),P<0.00001]、术后经量减少率[RR=0.25,95%CI(0.12,0.56),P=0.0007]均显著低于、少于或短于对照组,术后子宫内膜厚度[MD=1.90,95%CI(1.68,2.13),P<0.00001]、术后再妊娠率[RR=6.26,95%CI(1.88,20.83),P=0.003]均显著高于对照组。结论地屈孕酮联合戊酸雌二醇能降低人工流产术后患者的IUA发生率,减少术后阴道流血量,缩短术后阴道流血时间和术后月经复潮时间,增加术后子宫内膜厚度。
OBJECTIVE To systematically evaluate the efficacy of dydrogesterone combined with estradiol valerate for the prevention of intrauterine adhesion(IUA)and prognosis improvement after induced abortion.METHODS Retrieved from CNKI,Wanfang Data,VIP,CBM,PubMed,Embase and the Cochrane Library,randomized controlled trial(RCT)about conventional treatment combined with dydrogesterone and estradiol valerate(trial group)versus conventional treatment(control group)for the prevention of IUA in patients after induced abortion were collected from the inception to Dec.2024.After screening the literature,extracting data and evaluating the quality of literature,meta-analysis was performed using RevMan 5.4 software.RESULTS A total of 12 RCTs were included,involving 1109 patients.Meta-analysis showed that the postoperative incidence of IUA[RR=0.30,95%CI(0.22,0.41),P<0.00001],postoperative vaginal bleeding time[MD=-1.69,95%CI(-2.05,-1.32),P<0.00001],postoperative vaginal bleeding volume[MD=-10.78,95%CI(-12.19,-9.37),P<0.00001],postoperative menstrual resumption time[MD=-6.99,95%CI(-8.27,-5.71),P<0.00001],and the incidence of postoperative reduced menstrual flow[RR=0.25,95%CI(0.12,0.56),P=0.0007]were significantly lower,less or shorter than control group;postoperative endometrial thickness[MD=1.90,95%CI(1.68,2.13),P<0.00001]and the rate of postoperative re-pregnancy[RR=6.26,95%CI(1.88,20.83),P=0.003]were significantly higher than control group.CONCLUSIONS Dydrogesterone combined with estradiol valerate may reduce the incidence of IUA after induced abortion patients,decrease postoperative vaginal bleeding volume,shorten postoperative vaginal bleeding time and postoperative menstrual resumption time,and increase postoperative endometrial thickness.
作者
马越
张文艳
田晶
曹国锋
谭建伟
王姿婧
MA Yue;ZHANG Wenyan;TIAN Jing;CAO Guofeng;TAN Jianwei;WANG Zijing(Dept.of Pharmacy,Gansu Provincial Maternity and Child-care Hospital,Lanzhou 730050,China)
出处
《中国药房》
北大核心
2025年第14期1802-1806,共5页
China Pharmacy
基金
甘肃省妇幼保健院科研基金项目(No.GMCCH2024-3-29)。
关键词
地屈孕酮
戊酸雌二醇
宫腔粘连
人工流产
META分析
dydrogesterone
estradiol valerate
intrauterine adhesion
induced abortion
meta-analysis
