腹腔镜手术联合药物治疗子宫内膜异位症临床效果的Meta分析

目的:评价腹腔镜手术联合药物治疗子宫内膜异位症(EMs)的临床效果。方法:检索中英文数据库,纳入腹腔镜保守手术后联合孕三烯酮、GnRH-a、米非司酮等药物进一步巩固治疗EMs患者的随机对照试验,按Cochrane系统评价方法纳入有效数据,采用Meta分析评价腹腔镜手术联合药物治疗EMs的临床效果。结果:共纳入13篇文献。Meta分析结果显示,腹腔镜术后联合孕三烯酮可明显提高术后EMs的缓解率、降低复发率,效果与米非司酮相当,但不如GnRH-a效果果佳;在妊娠率方面,各药物的效果无明显差别。结论:腹腔镜联合药物治疗能明显提高EMs患者术后的缓解率,降低复发率,以GnRH-a效果更佳。

Meta-analysis for the effect of medicine plus laparoscopic surgery in the treatment of en-dometriosis

Objective: To evaluate the effect of laparoscopic surgery combined with drug treatment of endometriosis. Methods: We searched Chinese and English databases. Joint pregnant after conservative laparoscopic surgery included Gestrinone,GnRH-a,mifepristone or placebo and other drugs,such as further consolidation treatment of endometriosis patients randomized controlled trials,systematic approach according to the Cochrane review,Meta-analysis included valid data row evaluation of laparoscopic surgery combined with drug treatment of endometriosis clinical results. Results: 1521 literature were found,a total of 13 documents were ultimately selected. Meta-analysis showed that the joint Gestrinone laparoscopic surgery,mifepristone can significantly improve postoperative remission rate of endometriosis,reduce the relapse rate,as good as mifepristone,but is not as good as GnRH-a; in pregnancy,the no significant difference in the effect of each drug. Impaired liver function compared with mifepristone Gestrinone commonl. Conclusions: Laparoscopic combined GnRH-a therapy can significantly improve postoperative remission rate of endometriosis,reduce the relapse rate.