宫铜300宫内节育器脱落影响因素的meta分析

A meta-analysis of the influencing factors of intrauterine device Cu300 expulsion

目的分析和探讨宫铜300宫内节育器(intrauterine device,IUD)脱落的影响因素。方法检索PubMed、EMBASE、POPLINE等12个国内外数据库/网站,采用Open Meta-analyst软件对文献中单组数据进行合并分析。结果共检索到6 062篇中英文文献,最终纳入涉及宫铜300脱落结局指标的19篇文献。分析结果显示:(1)宫铜300脱落率在第18个月随访时最高,之后趋于稳定;(2)级别越高的机构开展的研究宫铜300脱落率越低;(3)人流术时放置和月经干净后放置宫铜300脱落率差异无统计学意义。结论研究机构级别可影响宫铜300的脱落率,建议不同级别的研究机构今后要严格按照统一的临床试验要求开展高质量的IUD相关随机对照试验研究,同时按照计划生育服务要求规范置器并加强随访,及时发现脱落,避免意外妊娠的发生。

Objective To explore the influencing factors of expulsion of intrauterine device（IUD） Cu 300. Methods PubMed, EMBASE, POPLINE and other 12 databases/website were searched. The articles retrieved were screened according to the inclusion and exclusion criteria, and then we used Open Meta - analyst software for data analysis. Results A total of 6 062 articles were retrieved, 19 articles related to the IUD expulsion were finally included. The results showed that： ① The expulsion rate was highest at 18 months follow - up and then tended to be stable;② The higher the level of research institution was, the lower the expulsion rate of IUD Cu300 was ; ③There was no significant difference in the expulsion rate when IUD Cu300 was placed after menstruation or induced - abortion. Conclusion Standardized training of IUD placement can reduce the occurrence of expulsion,and the users should be closely followed - up within 18 months after IUD placement in order to avoid unintended pregnancy.