米索前列醇联合缩宫素预防自然分娩产后出血有效性的Meta分析  

A Meta-analysis about the Validity of Misoprostol and Oxytocin in Preventing Hemorrhage after Spontaneous Labor

作　　者：宋茂芳[1] 柴建华[1] 洪程程 张燕华[1] 

机构地区：[1]崇州市人民医院,四川崇州611230 [2]成都医学院,四川成都610500

出　　处：《四川医学》2017年第3期319-323,共5页Sichuan Medical Journal

摘　　要：目的评价米索前列醇联合缩宫素预防自然分娩产后出血的有效性及安全性。方法计算机搜索PubMed(2010-2016.4)、CNKI(2010-2016.4)、万方数据库(2010-2016.4)、维普(2010-2016.4)、VIP(2010-2016.4)等数据库中关于米索前列醇联合缩宫素预防自然分娩产后出血的随机对照试验(RCT),用RevMan5.3对数据进行Meta分析。结果共纳入28篇RCT,包括4815例患者,结果显示产后2h出血量的差异有统计学意义[MD=-81.65,95%CI(-83.11,-80.18),P<0.00001];产后24h出血量的差异有统计学意义[MD=-85.20,95%CI(-86.92,-83.49),P<0.00001];产后出血发生率的差异有统计学意义[OR=0.29,95%CI(0.19,0.44),P<0.00001];产后不良反应发生率的差异无统计学意义[OR=1.35,95%CI(0.93,1.94),P=0.11]。结论基于现有的临床证据,米索前列醇联合缩宫素预防产后出血量、产后出血发生率方面均优于单用缩宫素,且不增加药物的不良反应。Objective The aim of this meta-analysis is to evaluate the validity and safety of misoprostol and oxytocin in preventing hemorrhage after spontaneous labor. Methods Random controlled tests（ RCT） about misoprostol and oxytocin in pre-venting hemorrhage after spontaneous labor were searched in several databases such as Pubmed（2010-2016. 4）,CNKI（2010-2016. 4）,Wanfang（2010 -2016. 4）,Weipu（2010. 2016. 4）and VIP（2010 -2016. 4）by computer. The dates were analyzed by RevMan5. 3. Results 28 RCTs were included which covered 4815 patients. The differences of the amounts of bleeding after 2hhad statistical significance[MD= -81. 65,95%CI（ -83. 11,-80. 18）,P〈0. 00001]. The differences of the amounts of bleeding after 24h had statistical significance[MD= -85. 20,95%CI（ -86. 92,-83. 49）,P〈0. 00001]. The differences of the incidence rate of postpartum hemorrhage had statistical significance[OR=0. 29,95%CI（0. 19,0. 44）,P〈0. 00001]. The differences of the in-cidence rate of postpartum adverse reactions had no statistical significance[OR=1. 35,95%CI（0. 93,1. 94）,P=0. 11]. Conclusion Based on the existing clinical evidence,we can conclude that misoprostol and oxytocin are better than oxytocin itself in preventing postpartum hemorrhage and do not increase the incidence of adverse events.

关 键 词：米索前列醇 缩宫素 产后出血 自然分娩 系统评价 META分析 

分 类 号：R714.461[医药卫生—妇产科学]