Prevention of pelvic inflammatory disease by the control of C-trachomatis infection
Prevention of pelvic inflammatory disease by the control of C-trachomatis infection
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DOI：
10.1016/s0020-7292(02)00185-6
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发表时间：
2002-09-01
影响因子：
3.8
通讯作者：
Templeton, A
中科院分区：
文献类型：
--
作者：
Honey, E;Templeton, A
目的：确定是否有证据表明沙眼衣原体（衣原体）筛查是预防盆腔炎（PID）的有效干预措施。研究方法：本文对文献进行了系统回顾，以评估对无症状的年轻女性进行下生殖道C。沙眼衣原体在预防盆腔炎及其主要后遗症、输卵管性不孕和异位妊娠中的作用。结果：有大量文献描述了下生殖道念珠菌感染的筛查。沙眼，但只有两个随机对照试验，两个生态研究和一个病例对照试验。对这些研究进行了分级，并汇总了证据。衣原体筛查是预防PID的有效干预措施的建议得到了2级证据（B级建议）的支持。然而，在文献中有很大的差距。只对少数妇女进行了研究，而且随访时间很短。这些研究主要使用宫颈拭子培养来诊断衣原体感染，而不是最近的核酸检测。女性在检测到下尿路感染C.沙眼仍不确定。结论：有证据支持B级建议，即使用培养物筛查衣原体在短期内可有效预防PID。需要进一步的随机对照试验来评估使用基于核酸的检测进行筛查并涉及更长的随访期。(C)2002年国际妇产科联合会。由Elsevier Science爱尔兰有限公司出版。保留所有权利。
Objectives: To determine if there is evidence to indicate that screening for Chlamydia trachomatis (chlamydia) is an effective intervention in the prevention of pelvic inflammatory disease (PID). Methods: A systematic review was made of the literature to assess the effectiveness of screening asymptomatic young women for lower genital tract infection with C. trachomatis in the prevention of PID and its major sequelae tubal infertility and ectopic pregnancy. Results: There is considerable literature describing screening for lower genital tract infection with C. trachomatis, but only two randomized controlled trials, two ecological studies and one case-controlled trial were identified. These studies were graded and the evidence pooled. The suggestion that screening for chlamydia is an effective intervention in the prevention of PID is supported by Grade 2 evidence (level B recommendation). However, there are large gaps in the literature. Only small numbers of women have been studied and the follow-up periods are short. The studies have been conducted using mainly culture of cervical swabs to diagnose chlamydial infection and not the more recent nucleic acid based tests. The risk of a woman developing PID following detection of lower tract infection with C. trachomatis is still uncertain. Conclusions: There is evidence to support a level B recommendation that screening for chlamydia using culture is effective in preventing PID in, the short term. Further randomized controlled trials are required to assess screening using nucleic acid based tests and involving longer follow-up periods. (C) 2002 International Federation of Gynecology and Obstetrics. Published by Elsevier Science Ireland Ltd. All rights reserved.