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目的运用meta分析方法评价宫铜200与宫内节育器(intrauterine device,IUD)使用相关终止率及其影响因素的关系,通过与其它含铜IUD的比较,对宫铜200安全性和有效性进行综合评估。方法通过计算机检索PubMed、EMBASE、CENTRAL等9种数据库和WHO/FDA/IUD生产企业/临床试验注册相关网站,使用Open Meta-analyst和RevMan 5.3.3进行数据的分析与合并。结果共检索到5 986篇文献,根据纳入及排除标准,最终纳入14篇文献,均为随机对照试验(randomized controlled trial,RCT)或准RCT。分析结果显示:(1)宫铜200随访6个月时月经间期放置的与IUD使用相关终止率低于人流术后即时(P<0.05);12个月时,不同时期之间差异无统计学意义(P>0.05)。(2)不同生产厂家的宫铜200与IUD使用相关终止率差异无统计学意义(P>0.05)。(3)在2年随访时,宫铜200与IUD使用相关终止率显著高于宫铜300、元宫200以及MCu功能型IUD(P<0.05);在1年和3年随访时宫铜200与IUD使用相关终止率显著高于活性γ型(P<0.05);在3年随访时宫铜200与IUD使用相关终止率显著低于活性165(P<0.05);与TCu 220 C、TCu 380A、母体乐250等3种IUD比较均无统计学意义(P>0.05)。结论首次报道宫铜200与IUD使用相关终止率与不同放置时期、生产厂家的meta分析结果;IUD的铜表面积大小和与IUD使用相关终止率高低的关系尚有待更多研究证实。
Objective To evaluate the relationship between the rate of termination of gonguang 200 and intrauterine device (IUD) and its influencing factors by meta-analysis, and compare the termination rate of gonguang 200 with its influencing factors. By comparing with other copper-containing IUDs, the safety and effectiveness of gonguang 200 Comprehensive Evaluation. Methods We searched 9 databases, including PubMed, EMBASE and CENTRAL, and related websites of WHO / FDA / IUD manufacturer / clinical trial registration by computer and used Open Meta-analyst and RevMan 5.3.3 for data analysis and combination. Results A total of 5 986 articles were retrieved. According to inclusion and exclusion criteria, 14 articles were finally included, all of which were randomized controlled trial (RCT) or quasi-RCT. The results of the analysis showed that: (1) The termination rate of IUD use during the follow-up period of 6 months at Gong-Cu-200 was lower than that of abortion (P <0.05); at 12 months, there was no statistical difference between different periods Significance (P> 0.05). (2) There was no significant difference in the termination rates of Gong Cu 200 and IUD between different manufacturers (P> 0.05). (3) At 2 years follow-up, the termination rate of Gong-Cu-200 with IUD was significantly higher than that of Gong-Cu-300, Yuan-Gong 200 and MCu-functional IUD The termination rate associated with the use of IUD was significantly higher than that of active type γ (P <0.05). The termination rate of uterine copper 200 with IUD was significantly lower than that of activity 165 at 3 years of follow-up (P <0.05) , Maternal music 250 and other three kinds of IUD were no statistical significance (P> 0.05). Conclusions The first report of the termination rates of gonguang 200 and IUD use and meta-analyzes of manufacturers during different placement periods; the relationship between the copper surface area of IUD and the termination rate associated with IUD use remains to be confirmed by more studies.