地屈孕酮联合戊酸雌二醇预防人工流产术后宫腔粘连及改善预后有效性的Meta分析

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中图分类号R977.1 文献标志码A 文章编号 1001-0408（2025）14-1802-05

DOI10.6039/j.issn.1001-0408.2025.14.20

ABSTRACTOBJECTIVETosystematicallyevaluatetheeficacyofdydrogesteronecombinedwithestradiolvalerateforthe preventionof intrauterineadhesion（IUA）and prognosis improvementafterinducedabortion.METHODSRetrieved fromCNKI， WanfangData，VIP，CBM，PubMed，EmbaseandtheCochraneLibraryrandomizedcontroledtrial（RCT）aboutconventional treatmentcombinedwithdydrogesteroneandestradiolvalerate（trialgroup）versusonventionaltreatment（controlgroup）forthe preventionofIUAinpatientsafterinducedabortion werecollctedfromtheinceptiontoDec.2024.Afterscrenngthelierature， extractingdataandevaluatingthequalityofliterature，meta-analysis was performedusingRevMan5.4software.RESULTSAtotal of12 RCTs were included，involving1109 patients.Meta-analysis showed that thepostoperative incidence of IUA [RR =0.30 ， （204号 95%CI （0.22，0.41）， P<0.000 01 ]，postoperative vaginal bleeding time [MD ， 95%CI （ -2.05 ， -1.32） ， P<0.000 01 ]， postoperative vaginal bleeding volume [MD=-10.78 ， 95%CI （ -12.19 ， -9.37） ， P<0.000 O1]，postoperative menstrual resumption time [MD ！ 95%CI （ -8.27 ， -5.71⟩ ， P<0.000 01 ]，and the incidence of postoperative reduced menstrual flow[RR =0.25 ， 95%CI （0.12，0.56）， P=0.000 7] were significantly lower，less or shorter than control group；postoperative endometrial thickness [MD= 1.90 ， 95%CI （1.68，2.13）， P<0.000 01 l and the rate of postoperative re-pregnancy [RR ⋅=6.26 ， 95%CI （1.88，20.83）， P=0.003 were significantly higher than control group. CONCLUSIONs Dydrogesterone combined with estradiol valerate mayreduce theincidenceofIUAafterinducedabortionpatients，decrease postoperativevaginal bleeding volume，shorten postoperative vaginal bleeding time and postoperative menstrual resumption time，and increase postoperative endometrial thickness.

KEYWORDSdydrogesterone；estradiol valerate；intrauterine adhesion；inducedabortion；meta-analysis

人工流产术是临床上常见的终止妊娠的有效方法，但该法会引起患者的子宫内膜损伤以及诱发各种并发症，其中宫腔粘连（intrauterineadhesion，IUA）是人工流产术后发生率较高、危害严重的并发症之一[1-2]。（剩余6921字）