围术期保温对剖宫产术母婴寒战预防效果的系统评价

发布时间：2018-12-23 10:20

【摘要】：目的系统评价围术期保温的有效性,以期为临床改善产妇及新生儿预后提供证据。方法计算机检索Pub Med、EMbase、The Cochrane Library(2015年2期)、Wan Fang Data、CBM和CNKI,搜集有关围术期保温对剖宫产术母婴寒战预防效果的随机对照试验(RCT),检索时限均为从建库至2015年7月。由2位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果最终纳入15个RCT,共计1 331例患者。Meta分析结果显示:保温组产妇体温变化[MD= 0.22,95%CI( 0.32, 0.13),P0.000 01]和寒战发生率[RR=0.53,95%CI(0.42,0.67),P0.000 01]明显低于对照组。在产妇术中出血量[MD= 13.77,95%CI( 33.95,6.42),P=0.18]和新生儿Apgar评分[MD=0.12,95%CI( 0.37,0.6),P=0.64]方面,保温组与对照组差异无统计学意义。结论围术期保温可减少产妇体温变化,降低产妇寒战发生率,但对产妇术中出血量与新生儿Apgar评分无影响。受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。
[Abstract]:Objective to evaluate the efficacy of perioperative heat preservation in order to provide evidence for clinical improvement of maternal and neonatal prognosis. Methods Pub Med,EMbase,The Cochrane Library (2015), Wan Fang Data,CBM and CNKI, were searched by computer. A randomized controlled trial (RCT),) was conducted to study the effect of perioperative heat preservation on the prevention of chills in infants and mothers undergoing cesarean section. The time limit for retrieval is from the construction of the database to July 2015. Two researchers independently sifted the literature, extracted the data and evaluated the bias risks involved in the study. The Meta analysis was carried out with Rev Man 5.3 software. Results A total of 1 331 patients with 15 RCT, were included. The results of Meta analysis showed that the body temperature of pregnant women in the thermal insulation group [MD= 0.2295 CI (0.32, 0.13), P0.00001] and the incidence of shivering [RR=0.53,95%CI (0.42 卤0.67)]. P 0.00001] was significantly lower than that of the control group. There was no significant difference between the heat preservation group and the control group in the amount of intraoperative bleeding [MD= 13.77-95CI (33.95 卤6.42), P0. 18] and neonatal Apgar score [MD=0.12,95%CI (0.37 卤0.6), P0. 64]. Conclusion Perioperative heat preservation can reduce the temperature change and the incidence of shivering in parturient, but it has no effect on intraoperative bleeding and neonatal Apgar score. These conclusions need to be verified by more high-quality studies, which are limited by the quantity and quality of the included studies.
【作者单位】：新疆医科大学第一附属医院麻醉科;
【基金】：新疆维吾尔自治区自然科学基金青年科学基金项目(编号:2015211C096)
【分类号】：R614

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