产后即时放置吉娜宫内节育器临床使用效果的meat评价

目的:比较研究产后即时放置吉娜宫内节育器(IUD)与产后未放置IUD或放置其他类型IUD的临床效果.方法:计算机检索中文数据库CNKI(2002～2013)、CBMdisc(2002～ 2013)、万方(2002～ 2013)、维普(2002～ 2013),纳入有关吉娜IUD临床随机或临床对照试验研究,然后采用RevMan 5.0软件进行meta分析.结果:共检索到367篇文献,根据纳入排除标准,最终纳入11篇已发表文献.结果:剖宫产后即时放置吉娜IUD与未即时放置IUD相比较,均未发现放置吉娜对产时、产后2h和24 h出血量以及恶露持续时间,术后产褥病发生率,子宫内膜炎的发生有影响.与胎盘娩出后同期放置Fix TCu220M IUD相比,吉娜组的不适主诉率(9.6％)明显低于Fix TCu220M组(P＜0.05).剖宫产后即时放置吉娜IUD与剖宫产后6个月放置TCu380 IUD比较,随访12个月时,吉娜组月经异常发生率和腰腹痛发生率均低于TCu380组(P＜0.05).结论:产后即时放置吉娜IUD不会对产妇的产后恢复造成不良影响,其无支架的设计能够有效减少副反应的发生.

A systematic review of clinical efficacy of GyneFix PP intrauterine device

Objective： To compare the clinical efficacy of postpartum GyneFix PP intrauterine device （IUD） insertion with control group （without postpartum insertion of IUD, other common-used IUI）s inserted in any period）. Methods： The medical databases including CNKI（2002-2013）,CBMdisc（2002-2013）,Wanfang Database（2002-2013）,VIP Database（2002-2013）were searched by computer. The randomized control trials and clinical control trials about： the comparison of GyneFix PP IUD with other common-used IUDs were included. A meta-analysis was performed with Roy- Man5.0 software. Results： Eleven articles from 366 literature were recruited according to the inclusion and exclusion criteria. The meta-analysis results showed that GyneFix PP IUD inserted after cesarean section had no effect on the intrapartum volume of bleeding, postpartum volume of bleeding in first 2 hours and 24 hours, as well as the duration of lochia, incidence of postoperative puerperalism and incidence of endometritis. Compare to Fix TCu220 M IUD inserted after delivery of the placenta, GyneFix PP IUD inserted after the same period had less complaints （P〈0.05）. Corn pare to TCu380 IUD inserted at 6 months after cesarean section, GyneFix PP IUD inserted after cesarean section immediately had lower incidence of menoxenia, lumbago, and abdominal pain at 12-month follow-up interval, showing statistically significant differences （P all〈0.05）. Conclusion： Immediately postpartum GyneFix PP insertion has no adverse effects on puerperal. The stentless structure can effectively reduce the occurrence of side effects.