摘要
目的:评价宫腔镜操作前使用米索前列醇促子宫颈成熟的有效性及安全性。方法:全面检索Pubmed、EMBASE、Google Scholar及the Cochrane Library’s Central Register of Controlled Trials数据库,筛选设置安慰剂或者未治疗组作为对照的RCT文章,选择Review Manager5.2软件对宫腔镜操作前需进一步扩张的宫颈数、宫颈扩张的宽度、扩张持续时间、疼痛评分及并发症进行Meta分析。结果:共筛选出31篇RCT文章,Meta分析结果表明应用米索前列醇可减少宫颈的进一步扩张[RR(95%CI):0.76(0.60-0.97,I2=82%],扩张后的宫颈宽度更宽[SMD(95%CI):(0.80cm(0.35,1.25),I2=96%],宫颈扩张持续时间更短[SMD(95%CI):(0.25(-0.40,0.91),I2=97%],但并不能降低患者的疼痛感[RR(95%CI)-0.26(-0.72-0.19;I2=87%],且更容易发生宫颈裂伤、恶心、阴道流血、腹痛及发热等并发症。结论:宫腔镜操作前应用米索前列醇可有效的软化宫颈,使患者受益,但其安全性有待更多、更严格的RCT实验进一步研究。
OBJECTIVE： To estimate the efficacy and safety of misoprostol use for cervical ripening in patients prior to hysteroscopy. METHODS： We searched Pubmed,EMBASE, Google Scholar, and the Cochrane Central Register of Controlled Trials （from inception to June 2014）. Randomized controlled trials （RCTs） of patients that used misoprostol compared with placebo or no treatment were included. The primary outcomes were the need for further cervical dilatation in order to perform the hysteroscopy , the cervical width prior to hysteroscopy, tme for cervical dilatation, pain score and complications. All parameters were analyzed in Revman 5.2 statistical software. RESULTS： A total of thirty-one RCTs met inclusion criteria. Misoprostol appeared to experience a lower risk for the need for further cervical dilatation to complete diagnostic hysteroscopy compared with placebo[RR （95% CI）： 0.76 （0.60-0.97, I2=82%], a signcantly greater cervical width compared with patients receiving placebo＇or no treatment[SMD （95% CI）： （0.80cm （0.35, 1.25）,I2=96%] and a shorter duration of cervical dilation[SMD （95% CI）：（0.25 （-0.40, 0.91）,I2=97%], however, prior to hysteroscopy using misoprostol didn＇t reduce the pain compared with control group [RR （95% CI）： -0.26 （-0.72-0.19;I2=87%]. There was an increase in side effects （cervical laceration, nausea,vaginal bleeding, abdominal painand fever） in the misoprostol group. CONCLUSION： Misoprostol administration prior to hysteroscopy appears to have beneficial effects on cervical ripening. But futher more and more strict RCT experiments should be performed in order to estimate the safety of misoorostol use for cervical ripening in nati^nt~ nrinr ta h,,~t
出处
《新疆医学》
2014年第11期20-25,共6页
Xinjiang Medical Journal
作者简介
通信作者：李超，344982925@qq．com。
