经椎管内镇痛行外倒转胎位术的有效性系统评价  

Efficacy of Intravertebral Analgesia for External Cephalic Version: A Systematic Review

作　　者：柳慧[1] 林雪梅[1] 周俊[2] 马玉珊[1] 

机构地区：[1]四川大学华西第二医院麻醉科,成都610041 [2]四川大学华西口腔医院麻醉科,成都610041

出　　处：《中国循证医学杂志》2010年第3期339-345,共7页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价应用椎管内镇痛行臀先露外倒转胎位术的有效性。方法计算机检索Cochrane Library(2009年第4期)、PubMed(1980～2009)、Ovid MEDLINE(1950～2009)、Ovid循证医学数据库(1991～2009)、EMbase(1980～2009)、CBM(1978～2009)和CNKI(1979～2009),按纳入和排除标准筛选椎管内镇痛在外倒转胎位术中应用的随机对照试验,提取资料及评价文献质量后,采用RevMan5.0.13软件对数据进行Meta分析。结果纳入7个研究,共620例产妇,其中5个研究质量较高,1个较低,1个不清楚。Meta分析结果显示,应用椎管内镇痛后臀先露胎头的外倒转成功率高于对照组,其差异有统计学意义[RR=1.53,95%CI(1.24,1.88)]。结论现有证据显示,椎管内镇痛较静脉给药全身镇痛或无任何镇痛措施,能明显提高臀先露外倒转胎位术的成功率。Objective To evaluate the efficacy of intravertebral analgesia for external cephalic version. Methods We electronically searched The Cochrane Library （Issue 4, 2009）, PubMed （1980 to 2009）, Ovid MEDLINE （1950 to 2009）, Ovid EBM Database （1991 to 2009）, EMbase （1980 to 2009）, CBM （1978 to 2009） and CNKI （1979 to 2009） to collect literature about intravertebral analgesia for external cephalic version. We screened randomized controlled trials （RCTs） according to the predefined inclusion and exclusion criteria, extracted data and evaluated the quality of the included studies, and then performed meta-analyses by using RevMan 5.0.13 software. Results Seven RCTs involving 620 women met the inclusion criteria. Five trials were of relatively high quality, and 1 of low quality and 2 not clear. The result of meta-analyses showed that intravertebral analgesia was superior in external cephalic version with a RR 1.53 and 95%CI 1.24 to 1.88. Conclusion Intravertebral analgesia can increase the successful rate of external cephalic version in the treatment of breech presentation compared with intravenous medicine for systematic use or no analgesia.

关 键 词：椎管内镇痛 外倒转胎位术 有效性 系统评价 随机对照试验 

分 类 号：R714.4[医药卫生—妇产科学]