输卵管外妊娠治疗选择的有效性:系统性审查和网络元分析
Bassel H Al Wattar1,2, Sarah A Solangon3,4, Lucrezia V de Braud3,4
1Beginning Assisted Conception Unit, Epsom and St Helier University Hospitals, London, UK.
概括
这一系统性审查发现,医疗治疗对管外妊娠 (TEP) 解决方案的预期管理没有显著的益处. 所有治疗都显示出比切除术更高的失败风险.
科学领域:
- 生殖医学 生殖医学
- 妇科紧急情况.
- 基于证据的医学 基于证据的医学
背景情况:
- 输卵管外妊娠 (TEP) 是一个频繁的妇科紧急情况.
- 目前的治疗选择缺乏最佳安全性和有效性的明确证据.
研究的目的:
- 系统地审查和网络分析TEP的预期,医疗和手术治疗的有效性.
- 为了比较TEP解决和治疗失败的各种干预措施.
主要方法:
- 31个随机试验的系统审查和网络元分析 (2938名女性).
- 在 MEDLINE,EMBASE 和 CENTRAL 数据库中进行了搜索.
- 评估偏差风险,异质性和网络不一致性;报告了相对风险 (RR) 和95%置信区间 (CI).
主要成果:
- 在TEP解决过程中,甲索特雷克萨特与预期管理没有显著的益处.
- 大多数保守的治疗方法表现出与预期管理相似的有效性.
- 所有的治疗方案都有较高的失败风险,相比salpingectomy.
结论:
- 没有足够的证据支持医疗TEP治疗而不是预期管理.
- 与其他干预措施相比,Salpingectomy的失败率较低.
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