缩宫素不同给药途径对剖宫产术后出血的预防效果:meta分析  

Efficacy of different delivery routes of oxytocin in preventing hemorrhage after cesarean section:a meta-analysis

作　　者：鲍林 尹毅青[1] 鹿曼曼 赵晶[1] Bao Lin;Yin Yiqing;Lu Manman;Zhao Jing(Department of Anesthesiology,China-Japan Friendship Hospital,Beijing 100029,China;Department of Anesthesiology,The Hospital of Shunyi District Beijing,Beijing 101300,China)

机构地区：[1]中日友好医院手术麻醉科,北京100029 [2]北京市顺义区医院手术麻醉科,101300

出　　处：《中华麻醉学杂志》2019年第5期530-533,共4页Chinese Journal of Anesthesiology

摘　　要：目的采用meta分析评价缩宫素不同给药途径对剖宫产术后出血的预防效果。方法计算机检索PubMed、Medline、Embase、Cochrane图书馆、数字化期刊全文数据库(万方)、中国期刊全文数据库、中文科技期刊全文数据库,手工检索会议论文,纳入椎管内麻醉下行择期剖宫产术中缩宫素通过子宫肌肉注射、静脉注射、静脉输注方式给药的临床随机对照研究。采用Cochrane系统评价法评价纳入文献质量。主要指标:术中失血量或手术前后Hb变化量;次要指标:使用缩宫素后血压和心率变化、心电图、子宫收缩情况及其它不良反应。结果纳入7篇研究,共2 325例患者,其中子宫肌注79例,静脉注射1 147例,静脉输注1 099例。与子宫肌肉注射组或静脉输注组比较,静脉注射组失血量差异无统计学意义(P>0.05);静脉注射组和静脉输注组失血量差异无统计学意义(P>0.05);与静脉注射组比较,静脉输注缩宫素对平均动脉压和心率的影响更小(P<0.01)。结论椎管内麻醉下剖宫产术中缩宫素适宜采用静脉输注途径给药。Objective To systematically review the effects of different delivery routes of oxytocin in preventing hemorrhage after cesarean section.Methods Databases including PubMed,Medline,Embase,Cochrane library,Wanfang Medical Database,China National Knowledge Internet(CNKI),VIP Database for Chinese Technical Periodicals were searched by computers and Conference papers were manually searched.The randomized,controlled clinical trials of oxytocin given by intramuscular injection,intravenous injection or intravenous infusion were included in elective cesarean section under spinal anesthesia.The quality of included literatures was evaluated by Cochrane systematic evaluation.The primary outcome measure was intraoperative amount of blood loss or change in Hb before and after operation.The secondary outcome measures were changes in blood pressure and heart rate,electrocardiogram,uterine contraction and other adverse reactions after using oxytocin.Results Seven studies involving 2 325 patients were included in this meta-analysis.Among the 2 325 patients,oxytocin was given through intramuscular injection in 79 cases,by intravenous injection in 1 147 cases and in the way of intravenous infusion in 1 099 cases.Compared with intramuscular injection group or intravenous infusion group,no significant change was found in the amount of blood loss during operation in intravenous injection group(P>0.05).There was no statistically significant difference in the amount of blood loss during operation between intravenous injection group and intravenous infusion group(P>0.05).Intravenously infusing oxytocin produced less effect on the mean arterial pressure and heart rate than intravenously injecting oxytocin(P<0.01).Conclusion Intravenous infusion is a suitable route for oxytocin delivery in cesarean section with spinal anesthesia.

关 键 词：剖宫产术 催产素 META分析 

分 类 号：R71[医药卫生—妇产科学]