本文選題：子宮切口瘢痕妊娠 + 甲氨蝶呤��； 參考：《廣西醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：應(yīng)用RevMan5.1和STATA12.0軟件進行Meta分析，比較甲氨蝶呤(methotrexate，MTX)經(jīng)B超引導(dǎo)下妊娠組織局部注射和肌肉注射兩種不同給藥途徑治療子宮切口瘢痕妊娠(cesarean scarpregnancy)的有效性和安全性。 方法：按照Cochrane協(xié)作網(wǎng)工作手冊的要求制定檢索策略，檢索的數(shù)據(jù)庫有PubMed、EMBASE、OVID、Cochrane、ScienceDirect、EBSCO、CNKI、CBM、VIP、萬方數(shù)據(jù)資源系統(tǒng)等數(shù)據(jù)庫，并輔以手工及其他檢索。搜集1978年至2013年12月的相關(guān)研究，納入評價MTX不同給藥途徑治療CSP療效的隨機對照臨床研究，采用RevMan軟件進行Meta分析，比較MTX不同給藥途徑治療CSP的有效性和安全性。 結(jié)果：初檢出文獻1611篇，僅有12篇隨機對照試驗符合納入標(biāo)準(zhǔn)，共計421名患者。Meta分析結(jié)果顯示：B超引導(dǎo)下妊娠組織局部注射MTX組與肌肉注射MTX組相比，治療成功率、血人絨毛膜促性腺激素（Human chorionic gonadotropin，HCG）下降到正常的時間、包塊消失的時間及輕度不良反應(yīng)，，差異均有具有統(tǒng)計學(xué)意義(P＜0.05)，兩組間嚴(yán)重合并癥差異無統(tǒng)計學(xué)意義（P＞0.05）。 結(jié)論： MTX治療CSP采用B超引導(dǎo)下妊娠組織局部注射的給藥方法療效優(yōu)于肌肉注射給藥方法，具有血HCG降到正常的時間短，包塊消失較快、輕度不良反應(yīng)少等優(yōu)點，對于子宮切除等嚴(yán)重合并癥，由于現(xiàn)有的資料尚不足以下結(jié)論。就現(xiàn)有研究而言，B超引導(dǎo)下局部注射MTX治療CSP的方法是安全、有效的。
[Abstract]:Objective: to evaluate the efficacy and safety of methotrexate MTX (methotrexate MTX) in the treatment of uterine incision scar pregnancy (cesarean scarpregnancy) by using Revman 5.1 and STATA12.0 software, and to compare the efficacy and safety of methotrexate MTX in the treatment of uterine incision scar pregnancy with local injection and intramuscular injection under the guidance of B-ultrasound. Methods: according to the work manual of Cochrane Cooperative Network, the search strategy was formulated. The database included PubMeden EMBASEN OVIDE CochraneScience Director EBSCICBMVIPand Wanfang data Resource system and so on, and was supplemented by manual and other retrieval. A randomized controlled clinical study was conducted to evaluate the efficacy of MTX in CSP from 1978 to December 2013. The efficacy and safety of MTX in CSP were analyzed with Revman software. Results: 1611 papers were first detected, only 12 randomized controlled trials met the inclusion criteria. A total of 421 patients. Meta-analysis results showed that the success rate of local MTX injection in pregnancy tissue guided by B-ultrasound was higher than that in intramuscular MTX group. Human chorionic gonadotropin (HCG) decreased to normal time, the time of mass disappearance and mild adverse reactions were significantly different (P < 0. 05), but there was no significant difference between the two groups in severe complications (P > 0. 05). Conclusion: MTX is more effective than intramuscular injection in the treatment of CSP with local injection of CSP under the guidance of B-ultrasound. It has the advantages of short time of blood HCG decreasing to normal, rapid disappearance of mass, and less mild adverse reactions. For severe complications such as hysterectomy, the available data are not sufficient to draw conclusions. As far as current studies are concerned, local injection of MTX under B-ultrasound guidance is safe and effective in the treatment of CSP.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R714.2

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