国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2014, Vol. 33 ›› Issue (3): 243-247.

• 论著 • 上一篇    下一篇

米非司酮联合米索前列醇与米非司酮联合依沙吖啶在瘢痕子宫中期妊娠引产中疗效比较的系统评价

廖静，何明凤，杨亚川，胡丽娜   

  1. 400010 重庆医科大学第二临床学院
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2014-05-15 发布日期:2014-05-15
  • 通讯作者: 胡丽娜

Application of Mifepristone Combined with Misoprostol or Ethacridine in Induced Labor in Mid-Pregnancy of Cicatricial Uterus：A Systematic Review

LIAO Jing，HE Ming-feng，YANG Ya-chuan，HU Li-na   

  1. The Second Affiliated Hospital of Chongqing Medical University，Chongqing 400010，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2014-05-15 Online:2014-05-15
  • Contact: HU Li-na

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摘要： 目的：系统评价目前主要采用的2种瘢痕子宫中期妊娠引产方法的疗效。方法：计算机检索MEDLINE、EMBASE、万方数据库、维普中文科技期刊数据库和中国知网（CNKI），检索时限均从建库至2013年11月，纳入关于瘢痕子宫中期妊娠引产且引产方法包括米非司酮联合米索前列醇及米非司酮联合依沙吖啶2种方法的随机对照试验，进行文献筛选及质量评价，采用RevMan5.2软件进行统计分析。结果：共纳入8篇文献，文献质量评价根据Jadad量表评分标准。Meta分析结果表明，米非司酮联合依沙吖啶组（试验组）与米非司酮联合米索前列醇组（对照组）相比，能明显缩短宫缩发动时间；（P＜0.000 01，WMD=-12.60，95% CI：-17.17～-8.03；P=0.000 5，WMD=-10.50，95%CI：-16.46～-4.55）， 降低胎盘胎膜残留率（Z=3.07，P=0.002，95% CI：0.37～0.80）、提高引产成功率（Z=2.31，P=0.02，95%CI：0.19～0.88），但2组的总产程（P=0.10，WMD=-2.16， 95%CI：-4.73～0.42）及产后24 h内阴道出血量（P=0.11，WMD=-29.01，95%CI：-64.12～6.09）差异均无统计学意义。结论：米非司酮联合依沙吖啶用于瘢痕子宫中期妊娠引产在宫缩发动时间、引产总时间、胎盘胎膜残留率及引产成功率方面均优于米非司酮联合米索前列醇，但前者在引产总产程及产后24 h内阴道出血量方面未显示明显优势。

关键词: 子宫, 瘢痕, 妊娠中期, 引产, 依沙吖啶, 米非司酮, 米索前列醇, Meta分析

Abstract: Objective：To systematically review the application effect of two main methods in induced labor in midtrimester pregnancy of cicatricial uterus. Two methods were the Mifepristone combined with misoprostol and the mifepristone combined with ethacridine. Methods：We searched MEDLINE，EMBASE，VIP Database，Wanfang Database and CNKI（from inception to Nov. 2013）. Randomized controlled trials（RCTs） of induced labor in mid-pregnancy of cicatricial uterus, with methods of the Mifepristone combined with Misoprostol（group A） or the Mifepristone combined with Ethacridine（group B）, were reviewed and evaluated. RevMan5.2 software was used for Meta-analysis. Results：Eight literatures were included, and quality of the literatures was based on the Jadad scale scoring criteria. Meta-analysis showed that the group B was significantly superior to the group A in the time of launching uterine contraction（P＜0.000 01，WMD=-12.60，95%CI：-17.17， -8.03） and induction（P=0.000 5，WMD=-10.50，95%CI：-16.46，-4.55），placental and fetal membrane residues（Z=3.07，P=0.002，95%CI：0.37，0.80） and induced labor success rate（Z=2.31，P=0.02，95%CI：0.19，0.88），and that there were no significant differences between two groups in the total stage of labor（P=0.10，WMD=-2.16， 95%CI：-4.73，0.42） and the amount of vaginal bleeding within 24 hours after delivery（P=0.11，WMD=-29.01， 95%CI：-64.12，6.09）. Conclusions：When the induced labor in midtrimester pregnancy of cicatricial uterus was used, the Mifepristone combined with Ethacridine was significantly superior to the Mifepristone combined with Misoprostol in the time of launching uterine contraction, total time of induced labor，placental and fetal membrane residue, and the success rate of induced labor, except the total stage of labor and amount of vaginal bleeding within 24 hours after delivery.

Key words: Uterus, Cicatrix, Pregnancy trimester, second, Labor, induced, Ethacridine, Mifepristone, Misoprostol, Meta-analysis