间苯三酚与米索前列醇在宫腔镜术前促宫颈成熟效果比较的Meta分析

Phloroglucinol and Misoprostol for cervix pretreatment before diagnostic hysteroscopy: a meta-analysis of randomized controlled trials

摘要:

目的 评价间苯三酚与米索前列醇在宫腔镜术前促宫颈成熟的临床效果和安全性。方法 计算机检索PubMed、MEDLINE、Springer、CNKI、VIP、CBM、WanFang Data等数据库，文献检索起止时间均从建库至2015年6月，同时检索纳入文献的参考文献，纳入探讨间苯三酚在宫腔镜术前促宫颈成熟的临床效果与安全性的随机对照试验，并逐个进行质量评价和资料提取。统计学分析采用RevMan 5.3软件。结果 该系统评价共收集到18个已完成的关于间苯三酚用于术前促宫颈成熟的临床效果和安全性分析的随机对照试验，共包括2 341例患者。Meta分析结果显示：应用间苯三酚比米索前列醇能更好地软化宫颈[OR=2.95，95%CI（1.96，4.45），P =0.000]；提高手术视野的清晰度[OR=9.50，95%CI（6.46，13.98），P =0.000]；能更好地缩短手术时间[OR=-4.12，95%CI（-5.75，-2.49），P =0.000]；能更好地减少术中漏水量[OR=0.22，95%CI（0.10，0.49），P = 0.000]；并且术后不良发应明显低于米索前列醇[OR=0.01，95%CI（0.00，0.04），P =0.000]，差异有统计学意义。 结论 本次Meta分析结果显示间苯三酚在用于宫腔镜术前预处理方面是安全有效的，故建议临床推广使用。

Abstract:

Objective To determine the efficiency and safety of Phloroglucinol and Misoprostol for cervix pretreatment before diagnostic hysteroscopy. Methods Trials were located through electronic searches of the PubMed, MEDLINE, Springer, CNKI, VIP, CBM, WanFang Data (from the date of establishment of the databases to June 2015). Bibliographies of the retrieved articles were also checked. Result A total of 18 trials involving 2 341 patients were included. The Meta-analysis showed: application of Phloroglucinol lenovo better open and dilate the cervix [OR = 2.95, 95 % CI (1.96, 4.45), P = 0.000]; To better clarity of the operative field [OR = 9.50, 95 % CI (6.46, 13.98), P = 0.000]; To better shorten the operation time [OR = -4.12, 95 % CI (-5.75, -2.49), P = 0.000]; To better able to reduce the amount of intraoperative leakage [OR = 0.22, 95 % CI (0.10, 0.49), P = 0.0002]; and postoperative adverse reactions should be significantly lower than Misoprostol [OR = 0.01, 95 % CI (0.00, 0.04), P = 0.000]. The difference was statistically significant. Conclusions Phloroglucinol is more effective and safer than Misoprostol in inducing proper cervical priming and may be the optimal choice for cervical pretreatment before diagnostic hysteroscopy.