米非司酮配伍米索前列醇终止瘢痕子宫早期妊娠的有效性和安全性系统评价

Evaluation of efficacy and safety of mifepristone plus misoprostol for termination of early pregnancy in scar uterus

目的评价米非司酮联合米索前列醇终止瘢痕子宫孕早期的临床疗效和安全性。方法计算机检索Cochrane Library、PubMed、Medline、Embase、中国知网数据库、中国生物医学文献数据库、中文科技期刊全文数据库、中国学术期刊网专题全文数据库,检索时间从各数据库建库至2012年11月20日,同时辅助其他检索,搜集国内外关于米非司酮配伍米索前列醇终止瘢痕子宫早期妊娠的随机对照试验(RCT),根据纳入和排除标准筛选文献、提取资料和进行质量评价后,采用RevMan 5.1软件进行Meta分析。结果共纳入5篇RCTs,分析结果显示:与常规人工流产术相比,米非司酮配伍米索前列醇联合人工流产方案可以缩短手术时间(P<0.001),减少术中出血(P=0.03),降低不全流产(P<0.04)和人工流产综合征(P<0.001)的发生率。结论米非司酮配伍米索前列醇联合人工流产方案在终止瘢痕子宫早期妊娠方面较常规人工流产术更为安全和有效,值得临床推广使用。

Objective It is to evaluate the efficacy and safety of mifepristone plus misoprostol for termination of early preg- nancy in scar uterus. Methods Cochrane library, PubMed, Medline, Embase, CBM, CNKI and V[P was searched. The search was finished in November 20, 2012. RCTs of mifepristone plus misoprostol for termination of early pregnancy in scar u- terus were included. The quality of included studies were evaluated and analyzed by RevMan 5.1. Results Five RCTs invol- ving 954 patients were included. Meta analysis results suggested that compared with conventional artificial abortion alone, mifepristone plus misoprostol combined with artificial abortion had a statistically significant benefit in reducing the operation time （ P 〈 0. 001 ） and intraoperative bleeding （ P = 0.03 ） , decreasing incomplete abortion （ P 〈 0.04 ） and the incidence of artificial abortion syndrome （P 〈 0. 001 ）. Conclusion Mifepristone plus misoprostol combined with artificial abortion in early pregnancy termination of uterine scar is more safe and effective, it is worth for clinical use.