發(fā)布時間：2018-04-26 03:16

  本文選題：引產(chǎn) + 足月妊娠晚期�。� 參考：《福建醫(yī)科大學(xué)》2014年碩士論文

【摘要】：【目的】系統(tǒng)分析足月妊娠晚期選擇性引產(chǎn)的母嬰結(jié)局。 【方法】計(jì)算機(jī)檢索相關(guān)外文數(shù)據(jù)庫包括：Cochrane library、PubMed、Embase、生物醫(yī)學(xué)外文全文服務(wù)系統(tǒng)及Google學(xué)術(shù)搜索系統(tǒng)；同時檢索相關(guān)中文數(shù)據(jù)庫包括：中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫、中國知網(wǎng)、維普科技期刊和萬方數(shù)據(jù)庫。檢索時間截止至2014年2月。收集足月妊娠晚期以引產(chǎn)結(jié)束分娩的隨機(jī)對照研究，篩選文獻(xiàn)，提取數(shù)據(jù)資料，并按Cochrane協(xié)作網(wǎng)推薦的方法進(jìn)行系統(tǒng)評價，包括對入選研究進(jìn)行異質(zhì)性檢驗(yàn)，數(shù)據(jù)的整合分析，敏感性分析。 【結(jié)果】共納入9項(xiàng)符合要求的研究，共5737人，Meta分析結(jié)果表明：對照期待治療組，引產(chǎn)組羊水糞染率低且差異有統(tǒng)計(jì)學(xué)意義（18.18%versus25.05%，RR：0.69，95%可信區(qū)間：0.51-0.94，P=0.02）；引產(chǎn)組胎糞吸入率低且差異有統(tǒng)計(jì)學(xué)意義（1.4%versus3.2%，RR：0.44，95%可信區(qū)間：0.23-0.86，P=0.02）；其他指標(biāo)：剖宮產(chǎn)率（21.02%versus19.48%，RR：1.07，95%可信區(qū)間：0.90-1.26， P=0.43），，新生兒窒息（1.27%versus0.83%，RR：1.43，95%可信區(qū)間：0.45-4.48，P=0.54），新生兒轉(zhuǎn)新生兒重癥監(jiān)護(hù)室（11.41%versus12.63%，RR：0.91，95%可信區(qū)間：0.78-1.05，P=0.2），圍產(chǎn)兒死亡率（0%versus0.22%，RR：0.29，95%可信區(qū)間：0.07-1.18，P=0.08）及新生兒出生后5分鐘阿普加評分7分（0.91%versus1.27%，RR：0.73，95%可信區(qū)間：0.44-1.19，P=0.2）結(jié)果的差異無統(tǒng)計(jì)學(xué)意義。 【結(jié)論】對妊娠時間超過41周的單胎、頭位、無妊娠合并癥、并發(fā)癥的孕婦進(jìn)行引產(chǎn)并未增加剖宮產(chǎn)、新生兒窒息、圍產(chǎn)兒死亡等風(fēng)險，而能夠有效減少羊水糞染和胎糞吸入的發(fā)生。對于產(chǎn)前監(jiān)護(hù)條件允許的醫(yī)院，在正確評估風(fēng)險后，對低風(fēng)險足月妊娠晚期產(chǎn)婦可以積極引產(chǎn)結(jié)束妊娠，從而改善妊娠結(jié)局。
[Abstract]:Objective: to analyze the maternal and infant outcomes of selective induced labor in term pregnancy. [methods] the relevant foreign language databases were searched by computer, including: Cochrane libraryGoogle Embase, Biomedical Full-text Service system and Google academic search system, and the relevant Chinese databases included: Chinese Biomedical Literature Database, China knowledge Network. WIP Science and Technology Journal and Wanfang Database. The search time is up to February 2014. A randomized controlled study of term pregnancy ending with induced labor was collected, literature was screened, data was extracted, and systematic evaluation was carried out according to the method recommended by Cochrane Network, including heterogeneity test and data integration analysis. Sensitivity analysis [results] A total of 9 eligible studies were included, and a total of 5737 subjects were included in the meta-analysis. The feces staining rate of amniotic fluid in the induced labor group was low and the difference was statistically significant (18.18versus 25.05). There was a lower meconium uptake rate in the induced labor group with a low meconium uptake rate of 0.51-0.94 / 95%; a statistically significant difference in the meconium aspiration rate in the induced labor group; a significant difference was found in the RRv 0.4495% confidence interval 0.23-0.86%; other indicators: the cesarean section rate was 21.02versus 19.48RR1.0795% confidence interval 0.90-1.26, P0. 433,1.27versus0.8395% of the neonatal asphyxia. The confidence interval was 0.45-4.48, the newborns transferred to the neonatal intensive care unit 11.41versus 12.63N, the RR0.9195% confidence interval 0.78-1.05P0.2m, the perinatal mortality rate 0.22v RV 0.2995% confidence interval 0.07-1.18P0.08) and the Apgar score 0.91versus 1.27m at 5 minutes after birth. There was no significant difference in the results of the five minute Apgar score of 0.91 versus 1.27m and Rsquo: 0.7395% confidence interval 0.44-1.19P0.2. [conclusion] the risk of cesarean section, neonatal asphyxia and perinatal death were not increased in single pregnancy, head position, no complication and complications. It can effectively reduce the occurrence of amniotic fluid fecal staining and meconium aspiration. For the hospitals where prenatal care conditions permit, after assessing the risk correctly, the late term pregnancy at low risk can be induced to terminate the pregnancy actively, thus improving the outcome of pregnancy.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R719.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 胡靈群;李韻平;夏云;陶為科;趙培山;;從“無痛分娩中國行”看中國的分娩鎮(zhèn)痛[J];臨床麻醉學(xué)雜志;2013年02期

2 胡小平;楊春艷;;引產(chǎn)指征臨床證據(jù)的Meta分析[J];循證醫(yī)學(xué);2012年05期

本文編號：1804248