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目的运用meta分析方法评价宫铜200宫内节育器(intrauterine derice,IUD)妊娠率及其影响因素,通过与其它含铜IUD比较,对宫铜200有效性进行综合评估。方法通过计算机检索Pub Med、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 Metaanalyst和Rev Man 5.3.3进行数据分析与合并。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放置12、24和36个月时妊娠率分别为0.2%(95%CI:0%,0.3%)、1.8%(95%CI:0.3%,3.2%)、2.1%(95%CI:0.7%,3.5%)。(2)月经间期、人流术后即时、哺乳期等不同时期放置宫铜200 IUD 1年时妊娠率间未见差异有统计学意义(P>0.05)。(3)放置1年时宫铜200妊娠发生率显著低于TCu 220 C(P<0.05),放置2年时宫铜200妊娠率显著高于元宫220(P<0.05);放置3年时宫铜200妊娠率显著低于活性165(P<0.05)。与TCu 380 A、母体乐250、宫铜300、活性γ型、MCu功能型等IUD比较,在不同放置时间的宫铜200妊娠率未发现差异有统计学意义(P>0.05)。结论宫铜200妊娠率与其他类型IUD妊娠率相似。
Objective To evaluate the pregnancy rate and its influential factors of intrauterine dermis (IUD) by meta-analysis, and evaluate the effectiveness of Gong-Cu 200 by comparing with other copper-containing IUDs. Methods We searched 9 databases, including Pub Med, EMBASE and CENTRAL, and related websites of WHO / FDA / IUD manufacturer / clinical trial registration by computer and used Open Metaanalyst and Rev Man 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) Pregnancy rates of GK 200 at 12, 24 and 36 months were 0.2% (95% CI: 0%, 0.3%) and 1.8% (95% CI: 0.3%, 3.2% , 2.1% (95% CI: 0.7%, 3.5%). (2) There was no significant difference in pregnancy rate between 1-year and 1-year follow-up of uterine copper 200 IUD during menstrual cycle, abortion, lactation, and other periods (P> 0.05). (3) The incidence of pregnancy at the time of 1 year was significantly lower than that of TCu 220 C (P <0.05). The pregnancy rate of hysterical copper 200 after 2 years of placement was significantly higher than that of the Yuan 220 (P <0.05) Palace copper 200 pregnancy rate was significantly lower than 165 (P <0.05). Compared with the IUD of TCu 380 A, maternal music 250, Gong Cu 300, active γ and MCu functional types, there was no significant difference in the pregnancy rates of uterine copper between different placement times (P> 0.05). Conclusions MG-200 pregnancy rates are similar to those of other types of IUDs.