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目的:系统评价子宫内膜息肉和内膜息肉切除术对不孕症患者妊娠率的影响,旨在指导不孕症患者常规进行宫腔镜检查,以期及时发现内膜病变并实施手术治疗,从而提高妊娠率。方法:检索the Cochrane Central Register of Controller Trails(CENTRAL)、EMBASE、Pub Med,检索时间自各数据库建库开始截止2015年1月为止。查找有关子宫内膜息肉及内膜息肉切除术对不孕症患者妊娠率影响的观察性研究,通过Revman 5.3软件对筛选的文献数据进行Meta分析,结果通过RR值与相应的95%CI进行比较。结果:共有6篇文献,7组数据纳入。3篇关于有/无子宫内膜息肉对不孕患者妊娠率的影响的研究,共纳入内膜息肉患者454例,其中妊娠的有111例,妊娠率为24.45%(111/454)。无内膜息肉患者共5 595例,其中妊娠的有1 706例,妊娠率为30.49%(1 706/5 595)。结果显示内膜息肉会降低不孕患者妊娠率(RR=1.19,95%CI=1.01~1.40,P=0.030)。各研究间无明显异质性(P=0.410,I2=0%)。4篇关于内膜息肉切除术对不孕患者妊娠率的影响的文献。治疗组共222例,共有114例怀孕,妊娠率51.35%(114/222)。对照组227例,共有60例怀孕,妊娠率26.43%(60/227)。结果显示内膜息肉切除术可提高不孕患者妊娠率(RR=1.61,95%CI=1.01~2.57,P=0.050)。各研究间有中度的异质性(P=0.030,I2=65%)。结论:子宫内膜息肉是导致不孕症的重要因素之一。对于B超及子宫输卵管造影提示宫腔异常的不孕症患者,需常规排除是否存有子宫内膜息肉,一旦发现需尽早诊断,及时手术处理,从而提高妊娠率。
OBJECTIVE: To systematically evaluate the effect of endometrial polyps and endometrial polypectomy on the pregnancy rate of infertility patients, and to guide the routine infertility patients to hysteroscopy in order to detect endometrial lesions in time and perform surgical treatment, thus Improve pregnancy rate. METHODS: The Cochrane Central Register of Control Trails (CENTRAL), EMBASE, Pub Med were retrieved. The search time was up to January 2015 as of the database building. To investigate the impact of endometrial polyps and endometrial polypectomy on the pregnancy rate of infertility observed in the study by Revman 5.3 software screening of the literature data for meta-analysis, the results by the RR value compared with the corresponding 95% CI . Results: There were 6 articles and 7 sets of data were included. There were 454 cases of endometrial polyps, of which 111 cases were pregnant and the pregnancy rate was 24.45% (111/454). There were 5 595 patients without endometrial polyps, of whom 1 706 were pregnant and the pregnancy rate was 30.49% (1 706/5 595). The results showed that endometrial polyps will reduce the pregnancy rate of infertile patients (RR = 1.19, 95% CI = 1.01 ~ 1.40, P = 0.030). There was no significant heterogeneity between studies (P = 0.410, I2 = 0%). 4 articles about the effect of endometrial polypectomy on the pregnancy rate of infertility patients. A total of 222 cases of treatment group, a total of 114 cases of pregnancy, the pregnancy rate was 51.35% (114/222). The control group of 227 cases, a total of 60 cases of pregnancy, pregnancy rate was 26.43% (60/227). The results showed that endometrial polypectomy can improve the pregnancy rate of infertile patients (RR = 1.61,95% CI = 1.01 ~ 2.57, P = 0.050). There was moderate heterogeneity among studies (P = 0.030, I2 = 65%). Conclusion: Endometrial polyps is one of the important factors that cause infertility. For B ultrasound and hysterosalpingography prompted abnormal uterine infertility patients, the need to routinely rule out the existence of endometrial polyps, if found to be diagnosed as soon as possible, and timely surgical treatment, thereby increasing the pregnancy rate.