本文選題：圍絕經(jīng)期婦女 + 功能失調(diào)性子宮出血(功血)　； 參考：《新疆醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：評價第一代與第二代子宮內(nèi)膜射頻消融技術(shù)治療圍絕經(jīng)期功血的臨床療效。方法：檢索Cochrane Library、MEDLINE、EMBASE, ISI Web、CBM、中國生物醫(yī)學(xué)文獻數(shù)據(jù)庫、萬方醫(yī)學(xué)數(shù)據(jù)庫、CNKI等。納入第一代與第二代子宮內(nèi)膜射頻消融技術(shù)治療圍絕經(jīng)期功血的隨機對照試驗,對其方法及質(zhì)量進行系統(tǒng)評價。用RevMan5.0軟件進行統(tǒng)計分析。結(jié)果：①共納入7篇符合要求的RCT文獻,共計1218例患者。②根據(jù)隨機方法、分配隱藏、盲法、失訪、基線比較和等級描述等對所納入的研究行質(zhì)量評估,結(jié)果質(zhì)量7篇文獻為高質(zhì)量文獻。Meta分析結(jié)果：治療后12個月月經(jīng)失血圖(PBAC)減小百分比進行了異質(zhì)性檢驗結(jié)果示P=0.710.05, I2=0%,RR=-9.05,95%CI=[-24.92,6.82],分析可知,差異無統(tǒng)計學(xué)意義。治療后12個月閉經(jīng)率進行了異質(zhì)性檢驗結(jié)果示：OR=0.49,95%CI=[0.10,2.41],P=0.380.05,差異無統(tǒng)計學(xué)意義。即治療12個月后,第一代、第二代子宮內(nèi)膜射頻消融技術(shù)組患者閉經(jīng)率無明顯差異。對手術(shù)時間進行了異質(zhì)性檢驗結(jié)果示RR=-14.78,95%CI=[-18.67,-10.88], P0.00001,故差異有統(tǒng)計學(xué)意義。即第一代、第二代子宮內(nèi)膜射頻消融技術(shù)手術(shù)所需時間有差異,第二代子宮內(nèi)膜射頻消融技術(shù)手術(shù)時間比第一代短。對治療后12個月患者滿意度進行了異質(zhì)性檢驗結(jié)果示OR=4.37,95%CI=[0.24,81.14], P=0.320.05,故差異無統(tǒng)計學(xué)意義,即第一代、第二代子宮內(nèi)膜射頻消融技術(shù)治療后12個月患者滿意度無差異。結(jié)論：第一代與第二代子宮內(nèi)膜射頻消融技術(shù)都對圍絕經(jīng)期功血的治療安全有效,第二代子宮內(nèi)膜射頻消融技術(shù)手術(shù)時間短,利于在局部麻醉下完成,而且此遠(yuǎn)期療效較第一代更好,是一種較好的保守性治療手段。
[Abstract]:Objective: to evaluate the clinical effect of the first and second generation of endometrial radiofrequency ablation in the treatment of peri-menopausal dysfunctional blood. Methods: Cochrane Library MEDLINE EMBASE, ISI WebCVM, Chinese Biomedical Literature Database and Wanfang Medical Database were searched. A randomized controlled trial of radiofrequency ablation of the first and second generation endometrium for the treatment of peri-menopausal dysfunctional blood was carried out, and the methods and quality were systematically evaluated. Statistical analysis was carried out with RevMan5.0 software. Results 1218 patients were included in 7 RCT articles. A total of 1218 patients were assessed according to random methods, allocation of concealment, blind method, lost interview, baseline comparison and grade description. Results the results of 7 articles of high quality. Meta-analysis showed that the percentage of decrease of PBAC) in menstrual bleeding map was 0.710.05 in 12 months after treatment, and RR-9.05C95CI = [-24.92m6.82]. The results showed that there was no significant difference between the two groups. 12 months after treatment, the rate of amenorrhea was examined by heterogeneity test. The results showed that the ratio of 0. 49% to 95% CI = [0. 10 ~ 2. 41] was 0.380. 05, and there was no significant difference between the two groups. After 12 months of treatment, there was no significant difference in amenorrhea rate between the first generation and the second generation radiofrequency ablation group. The results of heterogeneity test of operation time showed that RRX-14.788% CI = [-18.67 7 -10.88], P 0.00001, so the difference was statistically significant. That is, the first generation, the second generation of endometrium radiofrequency ablation technique need different time, the second generation endometrial radiofrequency ablation technique is shorter than the first generation. The results of heterogeneity test on patients' satisfaction at 12 months after treatment showed that ORX 4.37% 95 CI = [0.24 鹵81.14], PX 0.320.05, so there was no significant difference between the first generation and the second generation of endometrial radiofrequency ablation technique 12 months after treatment. Conclusion: both the first generation and the second generation of endometrial radiofrequency ablation are safe and effective in the treatment of peri-menopausal dysfunctional blood. The second generation of endometrial radiofrequency ablation has a short operation time and is beneficial to the completion of local anesthesia. And this long-term effect is better than the first generation, is a better conservative treatment.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R711.52

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