[1]欧阳振波*,钟碧婷,魏世远,等.高强度聚焦超声与子宫动脉栓塞治疗剖宫产 瘢痕妊娠疗效对比的Meta分析[J].中国计划生育和妇产科,2020,(8):53-58.
　OUYANG Zhenbo*,ZHONG Biting,WEI Shiyuan,et al.A Metaanalysis of the effectiveness of highintensity focused ultrasound and uterine artery embolization in the treatment of cesarean scar pregnancy[J].Chinese Journal of Family Planning & Gynecotokology,2020,(8):53-58.
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高强度聚焦超声与子宫动脉栓塞治疗剖宫产 瘢痕妊娠疗效对比的Meta分析
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2020年8期
页码:
53-58
栏目:
论著与临床
出版日期:
2020-08-25

文章信息/Info

Title:
A Metaanalysis of the effectiveness of highintensity focused ultrasound and uterine artery embolization in the treatment of cesarean scar pregnancy
作者:
欧阳振波1*; 钟碧婷1; 魏世远2; 盘翠丽1; 吴嘉雯1; 许姣姣2
广东广州，广东省第二人民医院,1.妇科；2.生殖医学中心
Author(s):
OUYANG Zhenbo1*;  ZHONG Biting1;  WEI Shiyuan2; PAN Cuili1; WU Jiawen1; XU Jiaojiao2
1.Department of Gynecology；2.Reproductive Centre，Guangdong Second Provincial General Hosptial, Guangzhou Guandong 510317，P.R.China
关键词:
剖宫产瘢痕妊娠; 高强度聚焦超声; 子宫动脉栓塞; Meta分析
Keywords:
cesarean scar pregnancy; highintensity focused ultrasound; uterine artery embolization; Meta analysis
分类号:
R 7138
摘要:
目的研究高强度聚焦超声（highintensity focused ultrasound，HIFU）与子宫动脉栓塞（uterine artery embolization，UAE）对剖宫产瘢痕妊娠（cesarean scar pregnancy，CSP）的治疗效果。方法检索PuMed、万方及中国知网数据库，纳入HIFU与UAE治疗CSP的对比研究，评估文献质量，采用RevMan 52软件对术中出血量、阴道出血持续时间、血绒毛膜促性腺激素（human chorionic gonadotrophin，hCG）降至正常时间、月经恢复时间、住院时间、治疗成功率及住院费用等进行Meta分析。结果共纳入8项研究，1 070例CSP病例。Meta分析结果显示，在术中出血量、阴道出血持续时间及治疗成功率上，两种治疗方式比较差异无统计学意义（P>005）。HIFU治疗组的血hCG降至正常时间及月经恢复时间较UAE治疗组更长，但其住院时间更短、住院费用更低（P<005）。结论HIFU与UAE治疗CSP的疗效相当，且具有住院时间更短及治疗费用更低的优点。
Abstract:
ObjectiveThe therapeutic effect of highintensity focused ultrasound (HIFU) and uterine artery embolization (UAE) on cesarean scar pregnancy (CSP) was compared.MethodsThe PubMed, Wangfang and CNKI databases were searched for a comparative study of HIFU and UAE for CSP. The quality of the literature was evaluated. Metaanalysis of intraoperative blood loss, duration of vaginal bleeding, time for hCG reduction to an normal level, menstrual recovery time, hospitalization time, treatment success rate and hospitalization cost were preformed using RevMan 52 software.ResultsA total of 8 studies,1 070 cases of CSP were included. Metaanalysis showed that there was no significant difference between the two treatment methods in intraoperative blood loss, duration of vaginal bleeding and treatment success rate (P>005). Although the time for hCG reduction to an normal level and menstrual recovery time in HIFU treatment group were longer than that of the UAE treatment group, the hospitalization time was shorter and the hospitalization cost was lower in HIFU treatment group (P<005).ConclusionHIFU has the same effect as UAE in the treatment of CSP, and has the advantage of shorter hospitalization time and lower hospitalization cost.

参考文献/References:

［1］ 欧阳振波，钟碧婷，张艺，等. 剖宫产瘢痕妊娠的治疗进展［J］. 现代妇产科进展，2018，27（8）：622624. ［2］ MaheuxLacroix S,Li F,Bujold E, et al.Cesarean scar pregnancies:a systematic review of treatment options ［J］.J Minim Invasive Gynecol,2017,24(6):915925. ［3］ Zhenbo OuYang, Hongwei Li, Song Quan. The firstline approach for cesarean scar pregnancy: The most adopted being not the best［J］. Taiwan J Obstet Gynecol, 2016,55（5）:761762. ［4］ Gonzalez N, Tulandi T. Cesarean scar pregnancy:a systematic review ［J］. J Minim Invasive Gynecol, 2017,24(5):731738. ［5］ Birch Petersen K, Hoffmann E, Rifbjerg Larsen C, et al. Cesarean scar pregnancy: a systematic review of treatment studies ［J］. Fertil Steril, 2016, 105(4):958967. ［6］ 欧阳振波，钟碧婷，全松，等. 剖宫产瘢痕妊娠动脉造影的影像学特点及临床意义［J］. 中国计划生育学杂志，2019，27（2）：192195. ［7］ Chen L, Xiao S, Zhu X, et al. Analysis of the reproductive outcome of patients with cesarean scar pregnancy treated by highintensity focused ultrasound and uterine artery embolization:a retrospective cohort study［J］. J Minim Invasive Gynecol，2018，26（5）：883890. ［8］ Zhu X, Deng X, Wan Y, et al. Highintensity focused ultrasound combined with suction curettage for the treatment of cesarean scar pregnancy ［J］. Medicine (Baltimore),2015,94(18):e 854. ［9］ Xiao J, Zhang S, Wang F, et al Cesarean scar pregnancy: noninvasive and effective treatment with highintensity focused ultrasound ［J］. Am J Obstet Gynecol, 2014,211(4):356.e 17. ［10］Huang L, Du Y, Zhao C. Highintensity focused ultrasound combined with dilatation and curettage for cesarean scar pregnancy［J］. Ultrasound Obstet Gynecol, 2014,43(1):98101. ［11］朱小刚，邓新粮，薛敏. 高强度聚焦超声联合负压吸宫术治疗剖宫产瘢痕妊娠的临床研究 ［J］.中国实用妇科与产科杂志,2018，34（5）：563565. ［12］Zhu X, Deng X, Xiao S, et al. A comparison of highintensity focused ultrasound and uterine artery embolisation for the management of caesarean scar pregnancy ［J］. Int J Hyperthermia,2016,32(2):144150. ［13］Hong Y, Guo Q, Pu Y, et al. Outcome of highintensity focused ultrasound and uterine artery embolization in the treatment and management of cesarean scar pregnancy:a retrospective study ［J］. Medicine (Baltimore),2017,96(30):e 7687. ［14］Xiao J, Shi Z, Zhou J, et al.Cesarean scar pregnancy: comparing the efficacy and tolerability of treatment with highintensity focused ultrasound and uterine artery embolization［J］.Ultrasound Med Biol, 2017,43(3):640647. ［15］方善钰，陈林林，何林生，等. HIFU、UAE、宫腔镜手术治疗子宫瘢痕妊娠的疗效比较［J］. 实用临床医学，2018，19（10）：4954. ［16］魏杏茹，高艳华，董巍巍，等. 高强度聚焦超声消融治疗剖宫产术后子宫瘢痕部位妊娠的疗效 ［J］. 解放军医学院学报，2017，38（11）：10401042. ［17］代倩苓，郑艾，王薇，等. 高强度聚焦超声与子宫动脉栓塞介入术治疗 ［J］. 华西医学，2017，32（5）：723726. ［18］楚光华，刘晨，胡春艳，等. 高强度聚焦超声与子宫动脉栓塞术辅助治疗剖宫产瘢痕妊娠的临床效果比较 ［J］. 中华妇幼临床医学杂志（电子版），2018，14（5）：545522. ［19］方春云，石珍，汪芳，等. 药物、子宫动脉栓塞及高强度聚焦超声联合清宫对剖宫产瘢痕妊娠的疗效比较 ［J］. 中国妇幼保健，2013，28（31）：52005202. ［20］中华医学会妇产科学分会计划生育学组. 剖宫产术后子宫瘢痕妊娠诊治专家共识（2016）［J］. 中华妇产科杂志，2016，51（8）：568572.

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备注/Memo

备注/Memo:
广东省医学科学技术研究基金（项目编号：A2020244）
更新日期/Last Update: 2020-08-25