输卵管手术对输卵管性不孕患者体外受精结局影响的Meta分析

Influence of operation on fallopian tube to tubal infertility after in vitro fertilisation:a Meta-analysis

目的系统评价输卵管手术对输卵管性不孕患者体外受精结局的影响。方法收集国内外发表的关于输卵管性不孕体外受精前手术治疗和对照组对比的随机对照试验研究文献,提取数据进行Meta分析,统计学分析采用RevMan 4.2软件。结果符合纳入标准的文献有4篇,共410例患者。Meta分析结果显示,输卵管性不孕患者体外受精前行腹腔镜下输卵管切除后妊娠率、活产率提高(P<0.05);异位妊娠率、流产率没有明显差异(P>0.05)。结论输卵管性不孕患者行腹腔镜下输卵管切除能提高体外受精的成功率。因本次系统评价纳入文献少、样本含量偏小,尚需要更多设计严谨的大样本随机对照研究来增加证据的论证强度。

Objective To assess the value of surgical treatment for tubal disease prior to in vitro fertilisation(IVF).Methods Published comparative studies on comparing a surgical treatment for tubal disease with a control group generated by randomization were retrieved and pooled the data from eligible studies (Meta analysis).Statistical analysis were performed with Ravman 4.2.Results Four randomised controlled trials,involving 410 patients were included in this review.The odds of pregnancy and live birth were increased with laparoscopic salpingectomy for hydrosalpinges prior to IVF(P<0.05).There was no significant difference in the odds of ectopic pregnancy or miscarriage (P>0.05).Conclusions Laparoscopic salpingectomy can improve the success rate of IVF for all women with hydrosalpinges prior to IVF treatment.This systematic review still required well-designed and large-scale randomized controlled trials to increase the strength of the evidence argument.