中国女性子宫肌瘤切除术后复发率及危险因素的meta分析
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重庆医科大学公共卫生与管理学院营养与食品卫生学教研室,重庆医科大学公共卫生与管理学院流行病学教研室,重庆医科大学公共卫生与管理学院流行病学教研室

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重庆医科大学公共卫生与管理学院青年骨干教师科研项目(Gwzk201303).


Recurrence rate and its risk factors after myomectomy in Chinese women:a systematic review and meta-analysis
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Department of Nutrition and Food Hygiene,School of Public Health and Management,Chongqing Medical University,Department of Epidemiology,School of Public Health and Management,Chongqing Medical University,Department of Epidemiology,School of Public Health and Management,Chongqing Medical University

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    摘要:

    目的 系统评价中国女性子宫肌瘤切除术后的复发率及危险因素,为临床制定预防策略提供依据。方法 全面检索PubMed、Web of Science、中国知网、中国生物医学文献数据库、中文科技期刊数据库和万方数据知识服务平台中的相关文献,按照预先制定的纳入和排除标准筛选文献,之后进行质量评价(NOS评价量表)和数据提取,最后采用Stata11.0软件进行meta分析和发表偏倚检测。结果 最终纳入25篇文献,病例总数为4 900例,复发1 331例。Meta分析结果显示,合并子宫肌瘤切除术后复发率为27%;初潮年龄<14岁、术前孕次0次、肌瘤数目多发和子宫肌瘤家族史是子宫肌瘤切除术后复发的危险因素,合并相对危险度(relative risk,RR)及95%CI分别为1.30(1.10,1.53)、1.27(1.12,1.45)、2.41(1.71,3.40)和 1.32(1.09,1.59)。结论 中国女性子宫肌瘤切除术后复发率较高;初潮年龄<14岁、术前孕次0次、肌瘤数目多发和子宫肌瘤家族史是术后复发的危险因素。建议临床上针对以上危险因素采取预防措施。

    Abstract:

    Objective To systematically review the incidence and risk factors of recurrence after myomectomy in Chinese women, so as to provide references for creating clinical prevention strategy. Methods Relevant literatures were searched in PubMed, Web of Science, CNKI, CBM, VIP and Wanfang Databases. Eligible studies were selected according to the predefined inclusion and exclusion criteria. Then the quality evaluation (NOS) and data extraction were conducted. Meta-analysis and publication bias examination were done using software Stata11.0. Results A total of 25 studies were included at last, including 4 900 patients and 1 331 recurrent cases. The results of the meta-analysis showed that the recurrence incidence after myomectomy was 27% in Chinese women. It was found that menarche age<14y, times of pregnancy(0), fibroid number≥2, and family history of uterine myoma had the pooled RR (95% CI) values as 1.30(1.10,1.53), 1.27(1.12,1.45), 2.41(1.71,3.40), and 1.32(1.09,1.59), respectively. Conclusion The recurrence rate after myomectomy is relatively high in Chinese women. Menarche age <14 y, no preoperative history of pregnancy, fibroid number ≥2, and family history of uterine myoma are positively related to recurrence after myomectomy, and early prevention measures should be taken accordingly.

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  • 收稿日期:2014-04-10
  • 最后修改日期:2014-07-10
  • 录用日期:2014-07-27
  • 在线发布日期: 2014-09-22
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