腹腔镜与开腹手术治疗宫外孕后生育结局比较的Meta分析.DOCVIP

临床医学论文-腹腔镜与开腹手术治疗宫外孕后生育结局比较的Meta分析 ???????????????? 作者：高明霞，高琦　李斌，张佩珍，田金徽，杨克虎 【摘要】? 目的 比较腹腔镜手术与开腹手术治疗异位妊娠后的生育结局。方法 计算机检索中文科技期刊全文数据库，中国期刊全文数据库，数字化期刊全文数据库，中国生物医学文献数据库，PubMed，EMBASE，SCI和Cochrane Library，并辅其他检索，纳入腹腔镜手术与开腹手术治疗输卵管异位妊娠后生育结局比较的队列研究，使用RevMan 5.0进行Meta分析。结果 共纳入12个研究，1 193例患者。Meta分析结果显示：腹腔镜手术组对比开腹手术组，术后1年内正常妊娠率、再次异位妊娠率，1年和3年内不孕率没有统计学差异，但开腹手术的3年内正常妊娠率高于腹腔镜手术，3年内异位妊娠率低于腹腔镜手术。结论 腹腔镜手术与开腹手术治疗异位妊娠后短期生育结局无差异，但从长远看来，开腹手术更利于异位妊娠患者术后正常受孕。 【关键词】? 宫外孕;腹腔镜;开腹手术;生育结局;Meta分析 　　[Abstract] Objective To compare the fertility outcome after laparoscopic operation and laparotomy in treatment of ectopic pregnancy.Methods We searched PubMed，EMBASE，SCI，Cochrane Library，Chinese Biomedical Literature Database，China Journal Fulltext Database，Chinese Medical Association Journals，and references of the included studies.Studies involving fertility outcome of ectopic pregnancy using laparoscopy compared with laparotomy up to July 2009.Data were evaluated and extracted by two reviewers independently with designed extraction form.The Cochrane Collaboration’s RevMan 5.0.1 software was used for data analyses.Results 12 studies(involving 1 193 patients)were included.Meta analysis showed that laparoscopy compared with laparotomy，the normal pregnancy rate and second ectopic pregnancy rate in one year had no difference，barren rate in one year and three years have no difference，but the three years’normal pregnancy rate of laparoscopy was higher than laparotomy，the three years’ second ectopic pregnancy rate was lower than laparotomy.Conclusion Uses laparoscopy and laparotomy treating for ectopic pregnancy，the fertility outcome has no difference in a short period，but in the long run，laparotomy is better to ectopic pregnancy patients for their normal pregnancy after surgery. 　　[Key words] ectopic pregnancy;laparoscopy;laparotomy;fertility outcome;Meta analysis 　　异位妊娠是妇科常见疾病，其发病率有逐年上升的趋势[1]。治疗异位妊娠常用的方法是开腹和腹腔镜手术，但对于应用开腹手术较腹腔镜手术更有利于保护患者的生育功能，邵军晖等[2]和Darwish等[3]报道，腹腔镜手术与开腹手术治疗异位妊娠术后输卵管复通率和宫内妊娠率差异显著，认为腹腔镜手术