剖宫产术前阴道消毒对预防术后感染效果的meta分析

发布时间：2019-02-13 04:48

【摘要】：目的评价剖宫产术前应用碘伏进行阴道消毒预防术后感染的效果。方法利用计算机检索PubMed、EMBASE、中国生物医学文摘数据库(CBM)、中国知网期刊全文数据库(CNKI)、维普中文期刊全文数据库(CQVIP)中所有相关随机对照研究,按照标准对其筛选后进行质量评价,采用RevMan 5.2软件进行meta分析。结果纳入9个随机对照研究,共3 024例研究对象,其中术前阴道消毒产妇1 508例,对照组1 516例。分析结果表明,剖宫产术前应用碘伏进行阴道消毒能够降低术后子宫内膜炎发生率(RR=0.55,95%CI 0.36~0.85,P=0.007),对胎膜早破产妇(RR=0.29,95%CI 0.16~0.52,P0.000 1)和临产产妇(RR=0.63,95%CI 0.41~0.96,P=0.03)子宫内膜炎发生率降低作用显著,而对胎膜未破产妇(RR=0.73,95%CI 0.50~1.08,P=0.11)和未临产产妇(RR=0.79,95%CI 0.53~1.17,P=0.24)的降低作用不显著。阴道消毒并不能降低术后切口感染率(RR=0.80,95%CI 0.53~1.22,P=0.30)和术后发热发生率(RR=0.92,95%CI0.76~1.11,P=0.37)。结论剖宫产术前给予阴道消毒能减少术后子宫内膜炎发生率,对胎膜早破产妇或临产产妇作用显著,但并不能降低术后切口感染率和发热率。
[Abstract]:Objective to evaluate the effect of vaginal disinfection with iodophor before cesarean section to prevent postoperative infection. Methods PubMed,EMBASE, Chinese Biomedical Abstract Database (CBM),) was used to retrieve all the related randomized controlled studies in (CNKI), Weip Chinese Journal Full-text Database (CQVIP). The quality was evaluated according to the standard and meta analysis was carried out with RevMan 5.2 software. Results A total of 3 024 subjects were enrolled in 9 randomized controlled studies, including 1 508 cases of vaginal disinfection before operation and 1 516 cases of control group. The results showed that vaginal disinfection with iodophor before cesarean section could reduce the incidence of endometritis after cesarean section (RR=0.55,95%CI 0.36 ~ 0.85% P0. 007), and could reduce the incidence of endometritis in women with premature rupture of membranes (RR=0.29,95%CI 0.16 卤0.52). The incidence of endometritis in parturient and parturient (RR=0.63,95%CI 0.41 卤0.96 P0.03) was significantly decreased, but in unbroken fetal membrane (RR=0.73,95%CI 0.50 卤1.08), the incidence of endometritis in parturient was significantly lower than that in parturient without rupture of fetal membrane (RR=0.73,95%CI 0.50 卤1.08). The decrease of P0. 11 and RR=0.79,95%CI 0. 53 ~ 1. 17 P0. 24 was not significant. Vaginal disinfection could not reduce the infection rate of incision (RR=0.80,95%CI 0.53) and the incidence of postoperative fever (RR=0.92,95%CI0.76~1.11,P=0.37). Conclusion vaginal disinfection before cesarean section can reduce the incidence of endometritis after operation, and has a significant effect on premature rupture of membranes or parturient, but it can not reduce the infection rate and fever rate of incision after cesarean section.
【作者单位】：第二军医大学长征医院妇产科;济南军区青岛第二疗养院体检中心;
【分类号】：R719.8

【参考文献】