不同用药途径对米索前列醇足月妊娠引产影响的Meta分析

A meta-analysis for the effects of misoprostol on the term labor induction between vaginal and oral administration

目的 评价与比较米索前列醇 (Misoprostol,简称Miso)足月妊娠引产选择口服与阴道用药两种不同途径的效果及不良反应。方法 检索 1990年 1月至 2 0 0 2年 3月有关Miso引产的相关文献 10 8篇 ,筛选合格文献 ,提取数据资料 ,应用SAS中的meta分析软件包对各研究结果进行一致性检验和采用相应数学模型进行数据合并与分析。结果 符合入选标准的文献 7篇。从用药到阴道分娩的时间 5 0 μgMiso阴道用药组为 15 0h ,口服组为 2 0 4h ,合并估计的均数差为 - 0 4 6h (- 0 6 2h ,- 0 30h) ,P =0 0 11;宫缩异常两组的合并估计的率差为 11 3% (0 1% ,2 2 4 % ) ,P =0 0 4 7;新生儿窒息的合并估计的率差为1 92 % (- 0 5 7% ,4 4 % ) ,P =0 131。结论 米索前列醇足月妊娠引产中 ,阴道用药比口服用药的效率高 ,但宫缩异常发生率也较高 ,而新生儿结局差异无显著意义。

Objective To evaluate the efficacy and adverse effects of misoprostol on the term labor induction between vaginal and oral administration.Methods The literature related to misoprostol and term labor induction between Jan, 1990 and Mar, 2002 was collected and taken up for Meta analysis.Results Seven studies were selected for discussing the route of administration.The induction to delivery interval was 15.0h in 50μg misoprostol vaginal group,and 20.43h in oral group,the deviation was -0.46h(-0.62h,-0.30h),P=0.011;The estimated average rate deviation of abnormal uterus contraction was 11.29%(0.1%,22.4%),P=0.047;The estimated average rate deviation of newborn axyphy was 1.92%(-0.57%,4.4%),P=0.131.Conclusion In term labor induction vaginal administration of 50μg misoprostol is more effective,but abnormal uteri contraction rate is higher than oral administration.