地屈孕酮聯(lián)合戊酸雌二醇預(yù)防人工流產(chǎn)術(shù)后宮腔粘連及改善預(yù)后有效性的Meta分析
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中圖分類號R977.1 文獻(xiàn)標(biāo)志碼A 文章編號 1001-0408（2025）14-1802-05
DOI10.6039/j.issn.1001-0408.2025.14.20
ABSTRACTOBJECTIVETosystematicallyevaluatetheeficacyofdydrogesteronecombinedwithestradiolvalerateforthe preventionof intrauterineadhesion（IUA）and prognosis improvementafterinducedabortion.METHODSRetrieved fromCNKI， WanfangData，VIP，CBM，PubMed，EmbaseandtheCochraneLibraryrandomizedcontroledtrial（RCT）aboutconventional treatmentcombinedwithdydrogesteroneandestradiolvalerate（trialgroup）versusonventionaltreatment（controlgroup）forthe preventionofIUAinpatientsafterinducedabortion werecollctedfromtheinceptiontoDec.2024.Afterscrenngthelierature， extractingdataandevaluatingthequalityofliterature，meta-analysis was performedusingRevMan5.4software.RESULTSAtotal of12 RCTs were included，involving1109 patients.Meta-analysis showed that thepostoperative incidence of IUA [RR =0.30 ， （204號 95%CI （0.22，0.41）， P<0.000 01 ]，postoperative vaginal bleeding time [MD ， 95%CI （ -2.05 ， -1.32） ， P<0.000 01 ]， postoperative vaginal bleeding volume [MD=-10.78 ， 95%CI （ -12.19 ， -9.37） ， P<0.000 O1]，postoperative menstrual resumption time [MD ！ 95%CI （ -8.27 ， -5.71? ， P<0.000 01 ]，and the incidence of postoperative reduced menstrual flow[RR =0.25 ， 95%CI （0.12，0.56）， P=0.000 7] were significantly lower，less or shorter than control group；postoperative endometrial thickness [MD= 1.90 ， 95%CI （1.68，2.13）， P<0.000 01 l and the rate of postoperative re-pregnancy [RR ?=6.26 ， 95%CI （1.88，20.83）， P=0.003 were significantly higher than control group. CONCLUSIONs Dydrogesterone combined with estradiol valerate mayreduce theincidenceofIUAafterinducedabortionpatients，decrease postoperativevaginal bleeding volume，shorten postoperative vaginal bleeding time and postoperative menstrual resumption time，and increase postoperative endometrial thickness.
KEYWORDSdydrogesterone；estradiol valerate；intrauterine adhesion；inducedabortion；meta-analysis
人工流產(chǎn)術(shù)是臨床上常見的終止妊娠的有效方法，但該法會引起患者的子宮內(nèi)膜損傷以及誘發(fā)各種并發(fā)癥，其中宮腔粘連（intrauterineadhesion，IUA）是人工流產(chǎn)術(shù)后發(fā)生率較高、危害嚴(yán)重的并發(fā)癥之一[1-2]。（剩余6921字）