剖宫产腹壁切口子宫内膜异位症的循证医学研究

Evidence-based medical research of abdominal wall endometriosis from cesarean section

目的探讨腹壁子宫内膜异位症的发生与剖宫产腹壁切口的关系。方法通过计算机检索中国期刊全文数据库、万方数据库、重庆维普期刊数据库、EBSCO、PubMed，按照纳入和排除标准收集研究两种剖宫产腹壁切口类型的腹壁子宫内膜异位症的病例对照研究8篇，检索时间为1997—2013年，采用RevMan5．2软件进行Meta分析。结果横切口组与纵切口组腹壁子宫内膜异位症发生率的比较，差异有统计学意义[OR合并=1．42，95％CI为（1．10，1．85），Z=2．65，P=0．0081，本研究纳入文献的发表性偏倚的漏斗图分析，基本呈对称倒漏斗状。结论剖宫产术后腹壁子宫内膜异位症的发生与腹壁切口的选择关系密切，横切口易发生腹壁子宫内膜异位症。

Objective To discuss the relationship between abdominal wall endometriosis and cesarean abdominal incision. Methods Chinese Journal Full-text database,WanFang DATA,Chongqing VIP periodical database,EBSCO,PubMed from 1997 through 2013 was retrievaled to identify case-control studies about the abdominal wall endometriosis from two kinds of cesarean incisions.The quality of the included studies was assessed and the RevMan 5.2 software was used for Meta-analysis. Results There were significant differences between transverse incision group and vertical incision group of the incidence rate of abdominal wall endometriosis [combined odds ratio （OR） was 1.42 with 95% CI was （1.10,1.85）,Z=2.65,P=0.008].Funnel plot analysis was used to the publication bias of the including studies,basic symmetrical inverted funnel. Conclusion There is a close relationship between the occurrence of abdominal wall endometriosis and the choice of incision of abdominal wall,in which are mostly transverse incision.