摘要
目的比较剖宫产瘢痕妊娠(cesarean scar pregnancy,CSP)常用的几种治疗方法的疗效。方法检索中外数据库中治疗CSP的文献,将符合纳入标准的前瞻性临床对照试验进行荟萃分析。结果 72个试验纳入本研究,通过荟萃分析得到在治愈率、月经复潮时间、出血量等方面比较的数据。结论手术治疗优于子宫动脉栓塞术(uterine artery embolization,UAE)/子宫动脉化疗栓塞术(uterine arterial embolization chemotherapy,UAEC)后刮宫术(dilatation and curettage,D&C);腹腔镜病灶切除术优于经腹病灶切除术;阴式病灶切除术治疗外生型CSP优于腹腔镜病灶切除术;甲氨蝶呤(methotrexate,MTX)局部用药后D&C优于MTX全身用药后D&C;UAEC后D&C优于孕囊内MTX注射后D&C;UAE/UAEC后D&C优于直接D&C。
Objective Compare the efficacy of several commonly used treatments for cesarean scar pregnancy(CSP).Methods The literature on the treatment of CSP in Chinese and foreign databases was searched,and meta-analysis was performed on prospective clinical controlled trials that met the inclusion criteria.Results 72 trials were included in the study,and data comparing the cure rate,menstrual re-tidal time,and bleeding volume were obtained by meta-analysis.Conclusion Operetion is better than dilatation and curettage(D&C)after uterine artery embolization(UAE)/UAEC.Laparoscopic resection is better than laparotomy resection.Transvaginal surgery is better than abdominal surgery.D&C after local methotrexate(MTX)to treat CSP is better than D&C after systemic MTX.D&C after UAEC is better than D&C after gestational sac MTX injection.D&C after UAE/UAEC is better than directly D&C.
作者
张雪松
侯成祯
顾向应
ZHANG Xue-song;HOU Cheng-zhen;GU Xiang-ying(Department of Obstetrics and Gynecology,Tianjin Medical University General Hospital,Tianjin 300052,P.R.China)
出处
《中国计划生育和妇产科》
2019年第5期17-24,共8页
Chinese Journal of Family Planning & Gynecotokology
关键词
剖宫产瘢痕妊娠
荟萃分析
治疗方法的疗效
cesarean scar pregnancy
meta analysis
effects of the management(therapy/treatment)
