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手術治療卵巢子宮內(nèi)膜異位囊腫對妊娠結局利弊影響的Meta分析

發(fā)布時間:2018-11-18 17:00
【摘要】:目的:探討手術治療卵巢子宮內(nèi)膜異位囊腫(OEM)對妊娠結局利弊的影響。方法:檢索2014年12月以前在Pubmed、EMbase、The Cochrane Library、CBM、CNKI、Wan Fang等數(shù)據(jù)庫發(fā)表的關于手術治療OEM對妊娠結局利弊影響的文獻。對納入文獻進行質(zhì)量評價及數(shù)據(jù)提取,采用STATA11.0軟件進行Meta分析。結果:本研究納入13篇文獻,手術組1135例,非手術組856例,兩組基線均衡。Meta分析結果提示,對于患有r AFS I~II期OEM且有生育要求的育齡婦女,手術切除OEM能改善妊娠率(RR 1.35,95%CI 1.09~1.68,P=0.006);對于r AFS III~IV期患者,手術切除OEM未改善妊娠率(RR 1.66,95%CI 0.74~3.75,P=0.221)。對于患有直徑≥3cm或單側OEM的患者,手術切除OEM未改善妊娠率(RR 1.27,95%CI 0.80~2.02,P=0.305;RR 1.04,95%CI0.76~1.42,P=0.795)。對于未接受任何ART治療的OEM患者,手術切除OEM改善妊娠率(RR 3.56,95%CI 1.98~6.43,P0.001)。手術切除OEM未改善活產(chǎn)率(RR 0.81,95%CI 0.45~1.47,P=0.489)。結論:對于患有r AFS I~II期OEM且有生育要求的育齡婦女,手術切除OEM改善妊娠率,術后是否采取ART助孕對妊娠結局無明顯影響,推薦確診OEM后行手術切除OEM。對于患有r AFS III~IV期、直徑≥3cm或單側OEM且具有生育要求的育齡婦女,尚無證據(jù)支持手術切除OEM能改善妊娠結局。
[Abstract]:Objective: to investigate the effect of surgical treatment of ovarian endometriosis cyst (OEM) on pregnancy outcome. Methods: to search the literature published in Pubmed,EMbase,The Cochrane Library,CBM,CNKI,Wan Fang and other databases before December 2014 on the effect of surgical treatment of OEM on pregnancy outcome. The quality evaluation and data extraction of the literature were carried out, and the Meta analysis was carried out with STATA11.0 software. Results: this study included 13 articles, 1135 cases in the operative group and 856 cases in the non-operative group. The results of Meta analysis showed that: for women of reproductive age with r AFS I~II stage OEM and fertility requirements, Surgical resection of OEM could improve pregnancy rate (RR 1.35 / 95 CI 1.09 / 1.68 P0. 006). For r AFS III~IV patients, the pregnancy rate was not improved by resection of OEM (RR 1.6695 CI 0.74 3.75 P0. 221). For patients with diameter 鈮,

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