药物流产与手术流产比较可接受性的Meta分析

邹燕; 梁艳; 吴尚纯; 李幼平; 鄢琳; 梅玲; 张炬倩; 童琳

Abstract

邹燕,梁艳,吴尚纯,李幼平,鄢琳,梅玲,张炬倩,童琳.药物流产与手术流产比较可接受性的Meta分析[J].Chinese journal of Epidemiology,2006,27(1):68-71

药物流产与手术流产比较可接受性的Meta分析

Study on Meta analysis regarding the acceptability of medical abortion compared with surgical abortion

Received:May 30, 2005

DOI：

KeyWord: 药物流产手术流产可接受性 Meta分析

English Key Word: Medical abortion Surgical abortion Acceptability Meta2analysis

FundProject:卫生部中国循证医学中心基金资助(200135)

Author Name	Affiliation
Zou Yan	National Research Institute for Family Planning, Beijing 100081, China
Liang Yan	第二军医大学长征医院实验诊断科
Wu Shangchun	National Research Institute for Family Planning, Beijing 100081, China
Li Youping	四川大学华西医院临床流行病学与中国循证医学中心
Yan Lin	国家食品药品监督管理局药品评价中心
Mei Ling	四川大学华西临床医学院
Zhang Juqian	四川大学华西临床医学院
Tong Lin	四川大学华西临床医学院

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Abstract:

目的评价米非司酮配伍米索前列醇药物流产与手术流产终止早期妊娠的可接受性,为非意愿妊娠妇女选择流产方法提供参考和为临床医生的临床决策提供证据。方法检索MEDLINE、 EMBASE、Cochranelibrary、CBMdisc、CNKI、VIP等6个医学数据库,手工检索12种相关杂志,并追查参考文献。由2名评价员独立筛选、评价文献和提取数据。对没有异质性的文献进行Meta分析。结果纳入9篇文献(3565例病例)。流产前妇女认为药物流产痛苦更少(OR=466.51,95% CI:91.37~2381.88);而手术流产更快捷(OR=0.02,95%CI:0.01~0.06)。流产后妇女对两种流产方法满意度相似,差异无统计学意义(P=0.89);药物流产的再选择率更高(OR=2.72,95% CI:2.13~3.47);向他人推荐药物流产的比率也更高(OR=4.91,95%CI:2.16~11.16)。结论药物流产是一种痛苦小的方法,但不如手术流产快捷,其再次选择率和推荐给他人的比率高于手术流产。药物流产与手术流产比较各有利弊,二者的满意度相似,不能相互代替。

English Abstract:

ObjectiveTo analyze and evaluate the acceptability of mifepristone compatible with misoprostone versus conventional surgical abortion among women under unwanted early pregnancy,so as to help theunexpected pregnant women to choose the satisfactory abortion,and to provide the evidence for clinicians to make a proper clinical decision. Methods　Six medical databases were searched, including MEDLINE, EMBASE,Cochrane library,CBMdisc,CNKI and VIP,together with twelve journals hand2searched,and references of includedstudies additionally searched. Two qualified reviewers reviewed the original articles,evaluating qualities of articles,and extracting data independently. After heterogeneity test,the data was pooled using Revman software if capable,or descriptive analysis was applied. ResultsIn total, nine original clinical controlled trials were included,containing 3565 cases. Before abortion,more unwanted pregnant women chose the medical abortion because they believed medical abortion was less painful than surgical abortion ( OR = 466. 51,95 % CI : 91. 3722381. 88), but medical abortion was less time2consuming than surgical abortion ( OR = 0. 02, 95 % CI : 0. 0120. 06). Afterabortion,satisfaction with medical abortion was similar to that with surgical abortion,with insignificant difference( P = 0. 89). However,second choice and recommendation rates of medical abortion were much higher than those of surgical abortion with OR and 95 %CI as 2. 72,2. 1323. 47 and 4. 19,2. 16211. 16,respectively. Conclusions Medical abortion was less painful than surgical abortion and the rate of second choice and recommendation to others were all also higher than those of surgical abortion. However,the process of medical abortion was not as quick as surgical abortion but the satifacation of both methods seemed similar. Therefore,the two artificial abortion methods were not recommended to replace each other at the present time.

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