本文選題：子宮內(nèi)膜異位癥 + 復(fù)發(fā)��； 參考：《重慶醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：運用循證醫(yī)學(xué)理論，對子宮內(nèi)膜異位癥術(shù)后復(fù)發(fā)的危險因素進行系統(tǒng)評價。 方法：檢索Pubmed、CENTRAL、EMBASE、VIP、CNKI、萬方電子數(shù)據(jù)庫中關(guān)于子宮內(nèi)膜異位癥術(shù)后復(fù)發(fā)相關(guān)因素研究，按照已設(shè)定的排除納入標(biāo)準進行文獻初篩和全文篩選，對最終納入的文獻進行質(zhì)量評價。設(shè)計數(shù)據(jù)提取表格，提取納入文獻中相關(guān)數(shù)據(jù)。采用系統(tǒng)評價軟件Revman manager5.2進行數(shù)據(jù)統(tǒng)計分析，計算各因素合并統(tǒng)計量的均數(shù)差、相對危險度及其95%可信區(qū)間。 結(jié)果：經(jīng)過篩選，共納入相關(guān)文獻15篇，采用紐卡索-渥太華量表（Newcastle-Ottawa Scale，NOS）進行文獻的質(zhì)量評價，所納入的文獻NOS評分為6-8分。Meta分析結(jié)果顯示，術(shù)前使用子宮內(nèi)膜異位癥相關(guān)藥物暴露組與非暴露組術(shù)后復(fù)發(fā)風(fēng)險無顯著差異（RR=1.16,95%CI[0.95,1.43], P=0.15）；r-AFS分期高暴露組與非暴露組術(shù)后復(fù)發(fā)風(fēng)險有顯著差異（RR=2.04,95%CI[1.65,2.52], P＜0.05）；既往有子宮內(nèi)膜異位癥相關(guān)手術(shù)史暴露組與非暴露組術(shù)后復(fù)發(fā)風(fēng)險有顯著差異（RR=9.14,95%CI[2.44,34.25], P＜0.05）；術(shù)后妊娠暴露組與非暴露組術(shù)后復(fù)發(fā)率有顯著差異（RR=0.50,95%CI[0.33,0.76], P＜0.05）；復(fù)發(fā)組與非復(fù)發(fā)組在發(fā)病年齡上有顯著差異（MD=-1.33，95%CI[-1.97，-0.69]，，P＜0.05）；復(fù)發(fā)組與非復(fù)發(fā)組在初潮年齡有顯著差異（MD=-0.23，95%CI[-0.42，-0.03]，P＜0.05）。 結(jié)論：根據(jù)現(xiàn)有的納入資料，Meta分析結(jié)果顯示，r-ASF分期高、既往有內(nèi)異癥手術(shù)史、發(fā)病年齡小及初潮年齡早均是術(shù)后復(fù)發(fā)的危險因素；術(shù)后妊娠是術(shù)后復(fù)發(fā)的保護性因素；術(shù)前使用內(nèi)異癥相關(guān)藥物增加術(shù)后復(fù)發(fā)傾向。因每項指標(biāo)中納入的樣本數(shù)量限制，上述結(jié)論需更多高質(zhì)量的臨床研究加入，增加論證強度。
[Abstract]:Objective: to evaluate the risk factors of postoperative recurrence of endometriosis by using the theory of evidence-based medicine. Methods: the relevant factors related to postoperative recurrence of endometriosis were studied in Wanfang Electronic Database by retrieving Pubmedmedus CENTRALLAL EMBASE and VIPKI. The literature was screened and screened according to the established exclusion criteria, and the quality of the final included literature was evaluated. Design the data extraction form and extract the relevant data into the literature. The system evaluation software Revman manager5.2 was used to analyze the data. The mean difference, relative risk and 95% confidence interval of the combined statistics were calculated. Results: a total of 15 articles were selected and evaluated by Newcastle-Ottawa scale. The NOS score of the literature included was 6-8. Meta-analysis showed that, There was no significant difference in the risk of postoperative recurrence between the drug exposure group and the non-exposed group. There was significant difference in the risk of postoperative recurrence between the high exposure group and the non-exposed group (P < 0.05), and there was no significant difference in the risk of postoperative recurrence between the high exposure group and the non-exposed group (P < 0.05), and there was no significant difference in the risk of recurrence between the high exposure group and the non-exposed group (P < 0.05). There was significant difference in the risk of postoperative recurrence between the exposed group and the non-exposed group (P < 0.05), the recurrence rate of the pregnancy exposure group and the non-exposed group was significantly different (P < 0.05), P < 0.055.There was a significant difference between the relapsing group and the non-recurrence group in the age of onset (P < 0.05), and the difference between the recurrent group and the non-exposed group was significant (P < 0.05). The risk of recurrence was significantly higher in the recurrent group than that in the non-exposed group (P < 0.05); and there was a significant difference between the recurrent group and the non-exposed group in the age of the onset of the disease (P < 0.05), and there was a significant difference in the postoperative recurrence rate between the exposed group and the non-exposed group (P < 0.05). There was significant difference in menarche age between recurrent group and non-recurrence group (P < 0.05). Conclusion: according to the existing data, the results of meta-analysis showed that the risk factors of postoperative recurrence were high stage of r-ASF, history of endodontic surgery, young age of onset and early menarche, postoperative pregnancy was the protective factor of postoperative recurrence. Preoperative use of endodysm-related drugs increased the risk of recurrence after operation. Because of the limited number of samples included in each index, the above conclusions need more high quality clinical research to increase the intensity of demonstration.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R711.71

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