中国循证医学杂志

中国循证医学杂志

高强度聚焦超声治疗子宫肌瘤术后妇科并发症单组率的 Meta 分析

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目的 评估高强度聚焦超声(high-intensity focused ultrasound,HIFU)治疗子宫肌瘤的安全性,为临床实践与防治并发症提供参考。 方法 计算机检索 PubMed、The Cochrane Library(2016 年 2 期)、EMbase、CBM、CNKI 和 VIP 数据库,搜集所有 HIFU 治疗子宫肌瘤的随机对照试验(randomized controlled trial,RCT)和自身对照试验,检索时限均从 2005 年 3 月 1 日至 2016 年 2 月 15 日。由 2 名评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用 R 软件进行 Meta 分析。 结果 最终纳入 20 个研究,包括 2 405 例患者。经单组率的 Meta 分析结果显示:HIFU 治疗子宫肌瘤妇科并发症总发生率为 6.63%[95%CI(3.58%,12.28%)];其中阴道出血发生率为 5.82%[95%CI(3.22%,10.53%)],腹痛发生率为 10.02%[95%CI(4.77%,21.05%)]。 结论 当前证据显示 HIFU 治疗子宫肌瘤存在一定妇科并发症。受纳入研究的数量和质量的限制,上述结论仍需要更多研究予以证实。

Objective To analysis the safety of high-intensity focused ultrasound (HIFU) in the treatment of uterine fibroids and provide references for clinical practice and prevention of complications of gynecological diseases. Methods Databases including PubMed, The Cochrane Library (Issue 2, 2016), EMbase, CBM, CNKI, and VIP were searched to collect studies concerning the complications of HIFU for uterine fibroids from March 1st 2005 to February 15th 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using R software. Results A total of twenty studies involving 2 405 patients were included. The results of meta-analysis showed that complications rate of gynecological system induced by HIFU was 6.63% (95%CI 3.58% to 12.28%); among them, the incidence of vaginal bleeding was 5.82% (95%CI 3.22% to 10.53%), and the incidence of abdominal pain was 10.02% (95%CI 4.77% to 21.05%). Conclusion The current evidence shows that there is a certain amount of complications of HIFU for uterine fibroids. Due to the limited quantity and quality of included studies, the above results are needed to be validated by more studies.

关键词: 高强度聚焦超声; 子宫肌瘤; 并发症; Meta 分析

Key words: High-intensity focused ultrasound; Uterine fibroids; Complications; Meta-analysis

引用本文: 吴平勇, 陈文卫, 胡伟, 陈辽, 黄星月, 黄鑫. 高强度聚焦超声治疗子宫肌瘤术后妇科并发症单组率的 Meta 分析. 中国循证医学杂志, 2017, 17(3): 312-319. doi: 10.7507/1672-2531.201606084 复制

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