仿生物电刺激辅助治疗宫腔粘连术后疗效的Meta分析

Meta analysis of the efficacy of bioelectrical stimulation in the adjuvant treatment of intrauterine adhesions

目的通过Meta分析系统评价仿生物电刺激辅助治疗宫腔粘连术后患者的临床疗效。方法计算机检索Pubmed、Cochrane library、Embase、Web of Science等国外数据库,知网、万方、维普、中国生物医学等国内数据库,收集其从建库起至2022年2月间所有关于仿生物电刺激治疗宫腔粘连术后的临床疗效的随机对照试验,研究指标主要包括患者子宫内膜厚度变化、月经改善情况、妊娠率、术后粘连复发率、临床疗效、子宫动脉阻力指数(RI),并采用RevMan5.3软件对以上指标进行Meta分析。结果根据本研究的纳入和排除标准进行文献筛选、文献质量评价、数据提取,最终共纳入文献8篇,总病例数为894例,其中观察组446例,对照组448例;与对照组比较,观察组患者月经改善情况[RR=0.26,95%CI(0.17,0.38),P<0.00001]、妊娠率[RR=0.79,95%CI(0.65,0.97),P=0.02]、术后宫腔粘连复发率[RR=0.50,95%CI(0.37,0.68),P<0.00001]、临床疗效[RR=0.25,95%CI(0.13,0.48),P<0.0001]、子宫动脉阻力指数[MD=-0.12,95%CI(-0.19,-0.04),P=0.002]均优于对照组,差异有统计学意义;而观察组患者的子宫内膜厚度改善程度[MD=1.27,95%CI(0.73,1.81),P<0.00001]低于对照组,差异有统计学意义。结论与单纯常规治疗相比,宫腔粘连术后患者采用常规治疗联合生物电刺激在改善患者临床疗效方面具有一定的优势。

Objective The clinical efficacy of bioelectrical stimulation in patients after intrauterine adhesion was evaluated by Meta-analysis system.Methods Computer search of foreign databases such as Pubmed,Cochrane library,Embase,and Web of Science;CNKI,Wanfang,VIP,China Biomedical and other domestic databases,all randomized controlled trials on the clinical efficacy of bioelectrical stimulation for intrauterine adhesions from library establishment to February 2022 were collected,the study indicators mainly include patient endometrial thickness changes,menstrual improvement,pregnancy rate,postoperative adhesion recurrence rate,clinical efficacy,uterine artery resistance index(RI),The Meta-analysis of the above indexes was also performed using RevMan5.3 software.Results According to the inclusion and exclusion criteria,literature screening,literature quality evaluation and data extraction were conducted,and finally,8 articles and the total number of cases were 894,including 446 patients in the observation group and 448 patients in the control group.Compared with the control group,the improvement of menstruation[RR=0.26,95%CI(0.17,0.38),P<0.00001],pregnancy rate[RR=0.79,95%CI(0.65,0.97),P=0.02],recurrence rate of postoperative uterine adhesions[RR=0.50,95%CI(0.37,0.68),P<0.00001],clinical efficacy[RR=0.25,95%CI(0.13,0.48),P<0.0001],uterine artery resistance index[MD=-0.12,95%CI(-0.19,-0.04),P=0.002]in the observation group were better than those in the control group,with statistically significant differences;The improvement of endometrial thickness in the observation group[MD=1.27,95%CI(0.73,1.81),P<0.00001]was lower than that in the control group,with a statistically significant difference.Conclusion Compared with conventional treatment alone,the combination of conventional treatment and bioelectrical stimulation has certain advantages in improving the clinical efficacy of patients with intrauterine adhesions.