拉玛泽减痛呼吸法联合健康教育对初产妇妊娠结局影响的Meta分析  

Effects of Lamazer Pain-Relieving Breathing Combined with Health Education on Pregnancy Outcomes of Primiparas:A Meta-Analysis

作　　者：郑海燕[1,2] 徐梦 李秀霞 Zheng Hai-yan;Xu Meng;Li Xiu-xia(Nursing School,Hexi University,Zhangye Gansu 734000;Lanzhou University Evidence-Based Medical Center,Lanzhou Gansu 730000;Public Health School,Lanzhou City,Lanzhou Gansu 730000)

机构地区：[1]河西学院护理学院,甘肃张掖734000 [2]兰州大学循证医学中心,甘肃兰州730000 [3]兰州大学公共卫生学院,甘肃兰州730000

出　　处：《河西学院学报》2024年第2期8-18,共11页Journal of Hexi University

摘　　要：目的:运用系统评价的方法分析拉玛泽减痛呼吸法联合健康教育对初产妇妊娠结局的干预效果,为临床提出最优的助产干预方法。方法:通过计算机全面检索了12个中英文数据库,搜集拉玛泽减痛呼吸法联合健康教育的随机对照试验的文献,时间从建库起至2021年12月22日,采用Cochrane风险偏倚评估工具对纳入文献质量进行评价,通过RevMan 5.3软件和Stata 14.0软件进行纳入文献的敏感性分析和异质性检验,并采用固定效应模型或随机效应模型进行效应量的合并计算。结果:共纳入43项研究,包括11144例初产妇。经过Meta分析结果显示,与健康教育相比,拉玛泽减痛呼吸法联合健康教育能明显缩短初产妇第一产程时间[SMD=-1.63,95%CI(-1.99,-1.26)]、第三产程时间[SMD=-0.56,95%CI(-0.80,-0.32)]和总产程时间[SMD=-2.24,95%CI(-2.84,-1.64)],可减轻产痛[RR=0.94,95%CI(0.79,1.12)],提高自然分娩率[RR=1.25,95%CI(1.21,1.28)],差异有统计学意义(P<0.05)。结论 基于现有的证据表明,拉玛泽减痛呼吸法联合健康教育在初产妇分娩中具有明显的优势,可以降低妊娠不良结局,有效提高助产质量,保障母婴安全。但受到纳入研究质量和数量的限制,未来仍需要高质量大样本研究进一步验证。Objective:To systematically evaluate the intervention effect of Lamaze pain-relieving breathing combined with health education on the pregnancy outcomes of primiparous women,and to propose an optimal midwifery intervention method for clinical practice.Methods:Twelve Chinese and English databases including China Biomedical Literature Database(CBM),Chi-na National Knowledge Infrastructure Database(CNKI),Wanfang Database,VIP database,Duxiu,PubMed,Embase,Web of Science,The Cochrane Library,Ovid,Scopus,and ProQuest were comprehensively searched to collect literature on randomized controlled trials of Lamaze pain-relieving breathing combined with health education from their inception to December 22,2021.The Cochrane risk bias assessment tool was used to evaluate the quality of the included literature.Sensitivity analysis and hetero-geneity tests were performed using RevMan 5.3 software and Stata 14.0 software,and effect sizes were combined using fixed-ef-fect or random-effects models.Results:A total of 43 studies were included,encompassing 11,144 primiparas.Meta-analysis showed that compared with health education alone,Lamaze pain-relieving breathing combined with health education significant-ly shortened the duration of the first stage of labor[SMD=-1.63,95%CI(-1.99,-1.26)],the third stage of labor[SMD=-0.56,95%CI(-0.80,-0.32)],and the total duration of labor[SMD=-2.24,95%CI(-2.84,-1.64)].It also increased the rate of nat-ural delivery[RR=1.25,95%CI(1.21,1.28)],with statistically significant differences(P<0.05).Conclusions:Based on the existing evidence,Lamaze pain-relieving breathing combined with health education has obvious advantages in primiparous deliv-ery,reducing adverse pregnancy outcomes and effectively improving the quality of delivery,ensuring the safety of mothers and in-fants.However,due to the limitations in the quality and quantity of included studies,high-quality large-sample studies are still needed for further validation in the future.

关 键 词：初产妇 拉玛泽呼吸法 健康教育 妊娠结局 META分析 

分 类 号：R473.71[医药卫生—护理学]