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目的:系统评价口服米索前列醇与安慰剂比较用于孕早期人工流产术前扩张宫颈的有效性和安全性。方法:检索相关文献并行Meta分析。据异质性检验结果采用固定效应模型、敏感性分析或随机效应模型等处理。结果:纳入文献5篇688例,国外文献质量高于国内。口服米索前列醇较之安慰剂宫颈扩张度好的比例较高,可降低术中出血量及疼痛发生率;在人工流产综合征(PAAS)、胃肠道副反应和用药后腹痛发生率及手术时间上两者差异无统计学意义。结论:国内原始研究质量有待提高,结局指标需更加规范。口服米索前列醇对于扩张宫颈有较好临床效果,而在其他有效性指标方面效果不明显,其安全性有待更多证据加以评价。
OBJECTIVE: To systematically evaluate the effectiveness and safety of oral misoprostol compared with placebo for the expansion of cervix before artificial abortion in early pregnancy. Methods: Search related literature and Meta-analysis. According to heterogeneity test results using fixed effects model, sensitivity analysis or random effects model and other treatment. Results: 688 cases were included in the literature, the quality of foreign literature is higher than that in China. The higher proportion of oral misoprostol than placebo cervical dilatation is good, can reduce intraoperative bleeding and the incidence of pain; in induced abortion syndrome (PAAS), gastrointestinal side effects and the incidence of abdominal pain after treatment and There was no significant difference in operation time between the two. Conclusion: The quality of the original research in China needs to be improved, and the outcome indicators need to be more standardized. Oral misoprostol for cervical dilatation has a good clinical effect, while in other effectiveness indicators of the effect is not obvious, its safety to be more evidence to be evaluated.