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1. 重庆医科大学附属第一医院妇科
2. 上海交通大学医学院附属国际和平妇幼保健院
纸质出版日期:2016,
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[1]牛婧雅,顾倪浩,袁瑞.关于子宫内膜息肉和内膜息肉切除术对不孕症患者妊娠率影响的系统评价[J].重庆医科大学学报,2016,41(03):286-291.
Niu Jingya, Gu Nihao, Yuan Rui. Effects of endometrial polyps and polypectomy on pregnancy rates of infertility patients:a systematic review[J]. Journal of Chongqing Medical University, 2016,41(3):286-291.
[1]牛婧雅,顾倪浩,袁瑞.关于子宫内膜息肉和内膜息肉切除术对不孕症患者妊娠率影响的系统评价[J].重庆医科大学学报,2016,41(03):286-291. DOI: 10.13406/j.cnki.cyxb.000805.
Niu Jingya, Gu Nihao, Yuan Rui. Effects of endometrial polyps and polypectomy on pregnancy rates of infertility patients:a systematic review[J]. Journal of Chongqing Medical University, 2016,41(3):286-291. DOI: 10.13406/j.cnki.cyxb.000805.
目的:系统评价子宫内膜息肉和内膜息肉切除术对不孕症患者妊娠率的影响
旨在指导不孕症患者常规进行宫腔镜检查
以期及时发现内膜病变并实施手术治疗
从而提高妊娠率。方法:检索the Cochrane Central Register of Controller Trails(CENTRAL)、EMBASE、Pub Med
检索时间自各数据库建库开始截止2015年1月为止。查找有关子宫内膜息肉及内膜息肉切除术对不孕症患者妊娠率影响的观察性研究
通过Revman 5.3软件对筛选的文献数据进行Meta分析
结果通过RR值与相应的95%CI进行比较。结果:共有6篇文献
7组数据纳入。3篇关于有/无子宫内膜息肉对不孕患者妊娠率的影响的研究
共纳入内膜息肉患者454例
其中妊娠的有111例
妊娠率为24.45%(111/454)。无内膜息肉患者共5 595例
其中妊娠的有1 706例
妊娠率为30.49%(1 706/5 595)。结果显示内膜息肉会降低不孕患者妊娠率(RR=1.19
95%CI=1.01
1
.40
P=0.030)。各研究间无明显异质性(P=0.410
I2=0%)。4篇关于内膜息肉切除术对不孕患者妊娠率的影响的文献。治疗组共222例
共有114例怀孕
妊娠率51.35%(114/222)。对照组227例
共有60例怀孕
妊娠率26.43%(60/227)。结果显示内膜息肉切除术可提高不孕患者妊娠率(RR=1.61
95%CI=1.01
2
.57
P=0.050)。各研究间有中度的异质性(P=0.030
I2=65%)。结论:子宫内膜息肉是导致不孕症的重要因素之一。对于B超及子宫输卵管造影提示宫腔异常的不孕症患者
需常规排除是否存有子宫内膜息肉
一旦发现需尽早诊断
及时手术处理
从而提高妊娠率。
Objective:To discuss whether endometrial polyps and endometrial polyp resection affect the pregnancy rate of infertility patients by conducting systematic review
to guide the routine hysteroscopy during the treatment of infertility patients
which may discover endometrial lesions timely and increase the pregnancy rate obviously. Methods:The Cochrane Central Register of Controller Trails(CENTRAL)
EMBASE
and Pub Med were searched from the date of their inception to 31 January 2015. Observational studies about endometrial polyps and endometrial polypectomy impact on infertility pregnancy were checked. The meta-analysis outcome was analyzed by software Revman 5.3. Risk ratio(RR)with 95% confidence interval(CI)was calculated. Results:Six studies presenting seven results were included. Three studies with a total of 6 094 participants were about whether endometrial polyp in patients with infertility exerts effect on pregnancy rate. There were 454 endometrial polyp cases
among which 112 cases were conceived and the pregnancy rate was 24.47%(112/454). A total of 5 595 cases had no endometrial polyp
among which 1 706 cases were conceived
and the pregnancy rate was 30.49%(1 706/5 595). The outcome showed that endometrial polyp was associated with increased risk of pregnancy rate in patients with infertility(RR =1.19
95% CI=1.01 to 1.40
P=0.030)and there was no heterogeneity among the studies(P=0.410
I2=0%). Four studies on whether polypectomy affect pregnancy rate in infertility were enrolled. There were 222 cases in the treatment group
among which 114 cases were conceived and the pregnancy rate was 51.35%(114/222). There were 227 cases in the control group
among which 60 cases were conceived and the pregnancy rate was 26.43%(60/227). The outcome showed that polypectomy was associated with increased risk of pregnancy rate in infertility patients(RR=1.61
95%CI=1.01 to 2.57
P=0.050)
with moderate heterogeneity among the studies(P=0.030
I2=65%). Conclusion:Endometrial polyp is one of important factors leading to infertility. Infertility patients whose outcome of ultrasound and/or hysterosalpingography is abnormal need to do routine hysteroscopy
in order to exclude endometrial polyp. Once endometrial polyp is diagnosed
surgical treatment should be intervened to improve the pregnancy rate.
子宫内膜息肉不孕症宫腔镜Meta分析系统评价
endometrial polypsinfertilityhysteroscopyMeta-analysissystematic review
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