绝经后妇女宫内节育器取出术前应用尼尔雌醇扩张宫颈的临床评价

目的:评价绝经后妇女宫内节育器(IUD)取出术前应用尼尔雌醇软化扩张宫颈的临床有效性和安全性。方法:计算机检索7个数据库,手工检索10种期刊,收集国内外有关尼尔雌醇用于绝经后妇女IUD取出术前软化扩张宫颈作用的临床(随机)对照试验。经过文献质量评价及筛选,能合并的数据做meta分析,不能合并的数据做定性系统评价。结果:共检索到70篇关于尼尔雌醇用于绝经后取器术前扩张宫颈的中文文献,按照研究的纳入和排除标准,最后纳入5篇临床对照试验。结果:与空白对照相比,使用尼尔雌醇后宫颈软化较好,明显提高了取器成功率,差异有统计学意义(P<0.05)。结论:尼尔雌醇是用于绝经后取器术前宫颈准备的一种有效药物,但因所检索到的文献论证强度相对较低,需要进一步设计高质量、大样本的随机对照试验予以证实。

Clinical study on the efficacy of nylestriol for cervical dilatation before removing IUD among postmenopausal women

Objective：To evaluate the efficacy of nylestriol for cervical dilatation before removing IUD among postmenopausal women. Methods： Seven medical databases were searched and ten journals hand-searching was conducted for collecting clinical （randomized） control trails involving nylestriol for laxation and dilation of the cervix before removing IUD among postmenopausal women. Meta-analysis was performed by Revman 4.2,and qualitative systematical review was applied for those data that couldn′t be meta-analyzed. Results： Seventy articles about nylestriol used for laxation and dilation of the cervix before removing IUD among postmenopausal women were found. According to the inclusion and exclusion criteria,only five articles were identified to further analyzed. It showed that the rate of successful removing IUD was improved after using nylestriol for laxation and dilation of the cervix. There were no side-effects reported in these articles. Conclusion： Nylestriol is one of the effective and safety drug for laxation and dilation of the cervix before removing IUD for postmenopausal women. However,as the quality of the included studies was not good enough,more randomized clinical trails should be conducted to support the conclusions mentioned above in the future.