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目的评价介入栓塞术治疗凶险型前置胎盘的有效性和安全性。方法检索1995年1月至2014年12月CochRane图书馆、Pub Med、EMBASE等外文数据库以及中国生物医学文献数据库、中国知网CNKI数据库、维普中文科技期刊数据库和万方数据库等中文数据库,选择在凶险型前置胎盘治疗中应用介入栓塞术的临床随机对照试验或临床对照试验文献,应用Stata 11.0统计软件,对符合纳入标准的临床研究进行Meta分析。结果共纳入13篇中文文献,Meta结果显示:相较于传统的治疗方法,介入栓塞术在术中出血量、手术时间、产后出血率、子宫切除率、弥散性血管内凝血发生率和产后24 h出血量等方面差异均有统计学意义(P均<0.05)。结论对于凶险型前置胎盘,使用介入栓塞术能够有效的减少出血量,降低子宫的切除率及术后出血率。
Objective To evaluate the effectiveness and safety of interventional embolization in the treatment of dangerous placenta previa. Methods The Chinese databases such as CochRane Library, Pub Med, EMBASE and other Chinese databases were searched from January 1995 to December 2014. The Chinese databases such as Chinese Biomedical Literature Database, CNKI Database, VIP Chinese Science Periodical Database and Wanfang Database were searched. Meta-analysis of clinical trials that met inclusion criteria was performed using Stata 11.0 statistical software in clinical randomized controlled trials or controlled trials of interventional embolization in the treatment of aggressive placenta previa. Results A total of 13 Chinese articles were included in the study. The results of Meta showed that compared with the traditional methods of treatment, the amount of bleeding, the time of operation, the rate of postpartum hemorrhage, the rate of hysterectomy, the incidence of disseminated intravascular coagulation and postpartum 24 h bleeding and other differences were statistically significant (P all <0.05). Conclusion For precarious placenta previa, the use of interventional embolization can effectively reduce the amount of bleeding, reduce the rate of uterine resection and postoperative bleeding.