米索前列醇联合10%葡萄糖酸钙注射液防治产后出血的Meta分析  

Meta-analysis of Misoprotol Combined with 10% Calcium Gluconate Injection in the Treatment of Postpartum Hemorrhage

作　　者：尹晴[1,2] 李斌飞[2] 

机构地区：[1]中山大学附属第一医院,广州510080 [2]中山大学附属中山医院麻醉科,广东中山528403

出　　处：《中国药房》2016年第12期1641-1644,共4页China Pharmacy

摘　　要：目的:系统评价米索前列醇联合10%葡萄糖酸钙注射液防治产后出血的疗效和安全性,以为临床提供循证参考。方法:计算机检索Pub Med、EMBase、Ovid、中国生物医学文献数据库、中国期刊全文数据库和中文科技期刊数据库,收集米索前列醇联合10%葡萄糖酸钙注射液(试验组)对比缩宫素(对照组)治疗产后出血的随机对照试验(RCT),对符合纳入标准的研究进行资料提取,并采用Cochrane系统评价员手册5.1.0进行质量评价,采用Rev Man 5.2统计软件进行Meta分析。结果:共纳入7项RCT,合计1 254例妊娠期妇女。Meta分析结果显示,与使用常规缩宫素比较,米索前列醇联合10%葡萄糖酸钙注射液可显著减少产后2h出血量[MD=-76.76,95%CI(-105.73,-47.79),P<0.001]、产后24 h出血量[MD=-118.28,95%CI(-167.78,-68.78),P<0.001],降低产后出血发生率[OR=0.19,95%CI(0.08,0.46),P<0.001],缩短第3产程时间[MD=-3.52,95%CI(-4.20,-2.84),P<0.001],差异均有统计学意义;两组妊娠期妇女术中出血量[MD=-61.31,95%CI(-121.98,-0.64),P=0.05]、新生儿1 min阿氏评分[MD=0.10,95%CI(-0.38,0.59),P=0.67]比较,差异均无统计学意义;试验组妊娠期妇女胸闷、气促、胃部不适发生率显著高于对照组[OR=18,95%CI(2.42,133.98),P=0.005],但症状较轻微,而发热、寒战以及恶心、呕吐、腹泻等发生率两组比较差异均无统计学意义。结论:米索前列醇联合10%葡萄糖酸钙注射液防治产后出血的疗效和安全性均较好。OBJECTIVE： To systematically review the efficacy and safety of misoprostol combined with 10% Calcium gluco- nate injection in the treatment of postpartum hemorrhage, and provide evidence-based reference for the clinical treatment. METH- ODS： Retrieved from PubMed, EMBase, Ovid, CBM, CJFD and VIP, randomized controlled trials （RCT） about misoprostol combined with 10% Calcium gluconate injection （test group） versus conventional oxytocin in the treatment of postpartum hemor- rhage were collected. Meta-analysis was performed by using Rev Man 5.2 software after data extract and quality evaluation by Co- chrane systematic review manual 5.1.0. RESULTS： Totally 7 RCTs were enrolled, involving 1 254 pregnant women. Results of Me- ta-analysis showed, compared with conventional oxytocin, misoprostol combined with 10% Calcium gluconate injection can signifi- cantly reduce 2 h postpartum hemorrhage [MD=- 76.76, 95% CI（- 105.73,- 47.79）, P〈0.001], 24 h postpartum hemorrhage [MD=- 118.28,95%CI（ -- 167.78, --68.78） ,P〈0.001] and the incidence of postpartum hemorrhage [OR=0.19, 95%CI（0.08, 0.46） ,P〈0.001], and shorten the 3rd delivery process [MD=-3.52, 95%CI（-4.20, -2.84）,P〈0.001], the differences were sta- tistically significant; there was no significant difference in the intraoperative hemorrhage [MD=-61.31,95%CI（-121.98,-0.64）, P=0.05] and neonatal 1 min Apgar score [MD=0.10,95%CI（- 0.38, 0.59）,P=0.67] in 2 groups. The incidences of chest dis- tress, breathlessness and stomach discomfort in test group were significantly higher than control group [OR=18, 95% CI （2.42, 133.98） ,P=0.005], but it was mild, and there was no significant difference in the incidence of fver, chills and nausea, vomiting, diarrhea and other adverse reactions. CONCLUSIONS： Both the efficacy and safety of misoprostol combined with 10% Calcium gluconate injection in the treatment of postpartum hemorrhage are good. Due to low quality and small-scale of included studies, more large-scale and long-term foll

关 键 词：缩宫素 米索前列醇 10%葡萄糖酸钙注射液 产后出血 META分析 

分 类 号：R714.7[医药卫生—妇产科学]