γ活性与常用闭合型活性宫内节育器比较的meta分析

A meta-analysis of active γ-IUD and other common closed-model IUDs

目的:运用循证医学系统评价方法比较活性γ型宫内节育器(IUD)与常用闭合型IUD的有效性。方法:检索8种医学数据库和9种相关杂志,并追查参考文献。由2位评价员根据纳入和排除标准筛查检索的文献,并进行meta分析。结果:纳入9篇文献,6299例进行分析,γ活性IUD与活性165IUD比较,在随访2、3年时累计带器妊娠率更低,合并OR及95%CI分别为0.36(0.19～0.70)和0.43(0.20～0.91)。随访1～5年的累计意外妊娠率和累计脱落率均更低,差异均有统计学意义,5年内的累计因症取出率相似。与宫铜200IUD比较,随访1年时,二者带器妊娠和脱落率相似,但γ活性IUD的因症取出率低于宫铜200。与宫铜300IUD比较,随访1年其累计带器妊娠率、累计脱落率和累计因症取出率低。结论:γ活性IUD与常用闭合型IUD相比具优势,值得推广使用。

Objective： To compare the effectiveness of active γ - IUD with common closed - model IUDs. Methods： Twelve medical databases and nine related journals were searched. And references of original articles were investigated. All literature were screened according to the inclusion and exclusion criteria by two reviewers, and a meta-analysis was performed. Re-sults： Nine literatures were included, and 6 229 cases were meta-analyzed. Compared with active 165 IUD, the two and three - year cumulative pregnancy rates with IUD in situ of γ - UD were lower, with the OR and 95% CI were 0.36 （0.19 - 0.70） and 0.43 （0.20 -0.91 ）. One - to five -year follow -up reveals that the cumulative unexpected pregnancy rate and cumulative expulsion rate were significantly lower, and the five - year cumulative discontinue rate for medical reasons of both IUDs was similar. Compared with GT200 IUD, 1 - year follow - up found that the discontinue rate for medical reason of active γ IUD was lower, while the pregnancy rate with IUD in situ and expulsion rate of both IUDs were similar. Moreover, com- pared with GT300 IUD, the one -year cumulative pregnancy rate with IUD in situ, cumulative expulsion rate and cumulative discontinue rate for medical reason of active γ- IUD were lower. Conclusion ： Active γ- IUD is worth using widely.