不同主动保暖策略预防剖宫产产妇术后寒战与低体温有效性的网状Meta分析  

A network Meta-analysis of the effectiveness of different active warming strategies in preventing post-operative chills and hypothermia in cesarean section women

作　　者：詹红霞 周茜 俞国红[2] ZHAN Hongxia;ZHOU Xi;YU Guohong(School of Nursing,Zhejiang Chinese Medical University,Hangzhou 310051,Zhejiang,China;Office of Management,the First Affiliated Hospital of Zhejiang Chinese Medicine University,Hangzhou 310000,Zhejiang,China)

机构地区：[1]浙江中医药大学护理学院,浙江杭州310051 [2]浙江中医药大学附属第一医院管理办公室,浙江杭州310000

出　　处：《中国现代医生》2023年第8期108-113,共6页China Modern Doctor

基　　金：浙江省中医药科技计划项目(2020ZA049)。

摘　　要：目的对多种用于改善剖宫产产妇术后寒战和低体温的保暖策略进行效果评估和比较,为剖宫产产妇最佳保暖策略提供循证依据。方法计算机检索PubMed、Web of Science、Medline、Embase、Cochrane Library、中国知网(CNKI)、万方数据库和维普数据库(VIP)公开发表的关于保暖策略对剖宫产产妇术后寒战和低体温的干预效果的随机对照研究,检索时限均自建库至2022年5月。由两名研究者独立进行质量评价和资料提取。使用Review Manager 5.3、ADDIS、STATA17.0软件进行网状Meta分析。结果本研究共纳入24篇文献,涉及2208例接受剖宫产手术的妇女。网状Meta分析结果显示,寒战控制率排序:强制空气升温+液体加温>艾盐包>液体加温+电热毯>强制空气升温>液体加温>电热毯>被动保暖;低体温控制率排序:强制空气升温+液体加温>液体加温>电热毯>强制空气升温>被动保暖。结论优先考虑应用强制空气升温+液体加温的保暖措施来降低剖宫产产妇寒战和低体温的发生,但仍需更多高质量且多中心大样本随机对照试验进行进一步验证。Objective To evaluate and compare the effects of various warming strategies for improving chills and hypothermia after cesarean section,and to provide evidence-based evidence for the best warming strategy for cesarean section women.Methods A computer search was conducted to search PubMed,Web of Science,Medline,Embase,the Cochrane Library,CNKI,Wanfang and VIP databases for randomized controlled trials on the intervention effect of warming strategies on post-cesarean section women with chills and hypothermia,and the retrieval time limit was from the establishment of the database to May 2022.Quality assessment and data extraction were performed independently by two investigators.Review Manager5.3,ADDIS,STATA17.0 software were used for network Meta-analysis.Results A total of 24 articles were included in this study,involved 2208 women who underwent cesarean section.The results of network Meta-analysis showed that the chilling control rate was ranked as follows:forced air warming+liquid warming>moxa salt pack>liquid warming+electric blanket>forced air warming>liquid warming>electric blanket>passive warmth;the control rate was ranked as follows:forced air warming+liquid warming>liquid warming>electric blanket>forced air warming>passive warming.Conclusion The current evidence shows that the application of forced air warming and liquid warming should be prioritized to reduce the occurrence of chills and hypothermia in cesarean section women,but more high-quality and multi-center large-sample randomized controlled trials are needed for further verification.

关 键 词：保暖策略 剖宫产 低体温 寒战 网状Meta分析 

分 类 号：R714[医药卫生—妇产科学]