摘要
目的:系统地比较挤压脐带与延迟断脐对早产儿的临床效果。方法:计算机检索TheCochrane Library、PubMed、WebofScience、EMBASE、ClinicalTrials.gov、中国知网、万方数据库和维普数据库中有关挤压脐带与延迟断脐对早产儿临床效果的随机对照试验。根据纳入和排除标准,对文献进行筛选,提取数据并进行文献质量评价,采用Revman 5.3软件进行Meta分析。结果:最终纳入8项随机对照试验,892例早产儿。Meta分析结果显示,挤压脐带降低了早产儿脑室内出血发生率[OR=0.64,95%CI(0.41,0.99),P=0.04]、提高了早产儿2岁时认知和语言能力[认知:OR=0.24,95%CI(0.07,0.77),P=0.02;语言:OR=0.45,95%CI(0.22,0.90),P=0.02],但在早产儿住院期间死亡率、出生24 h内血红蛋白及血细胞比容、胆红素峰值、新生儿坏死性小肠结肠炎、早产儿输血率方面,与延迟断脐效果相似,合并效应无统计学意义(P>0.05)。结论:与延迟断脐相比,挤压脐带降低了早产儿脑室内出血发生率,提高了早产儿2岁时认知和语言能力,但仍需要大样本、高质量的RCT进行验证。
Objectives:To systematically compare the effects of Umbilical Cord Milking(UCM)with those of Delayed Cord Clamping(DCC)on premature infants.Methods:Cochrane Library,PubMed,Web of Science,EMBASE,Clinical Trials.gov,CNKI,Wanfang Data and VIP database were searched for randomized controlled trials(RCTs)comparing the effects of UCM with those of DCC on premature infants.The studies were selected according to the inclusion and exclusion criteria,and the standard methodological procedures were used to extract the data and assess the quality.Data was analyzed by Revman 5.3.Results:Totally 8 eligible RCTs enrolling 892 premature infants were picked out.Meta-analysis showed that compared with DCC,UCM could reduce the incidence of intraventricular hemorrhages(IVHs)[OR=0.64,95%CI(0.41,0.99),P=0.04]and improve the cognitive and language ability of premature infants at the age of 2[Cognitive ability:OR=0.24,95%CI(0.07,0.77),P=0.02;Language ability:OR=0.45,95%CI(0.22,0.90),P=0.02].However,as to indicators like in-hospital mortality,hemoglobin level at birth,initial hematocrit level,maximum serum bilirubin,necrotizing enterocolitis and the need for transfusion,no significant differences were observed.Conclusion:UCM,when compared with DCC,may lower the risk of IVH and improve the cognitive and language ability of premature infants at the age of 2.However,large-scale studies with high quality are still needed.
作者
曹琳琳
魏媛
卢倪
倪胜莲
CAO Linlin;WEI Yuan;LU Jie;NI Shenglian(Peking University Third Hospital,Gynaecology and Obstetrics Department,Beijing,100191,China)
出处
《中国护理管理》
CSCD
北大核心
2020年第1期78-84,共7页
Chinese Nursing Management
基金
中国高龄孕妇早产防治策略和发生机制研究(2016YFC1000407).
关键词
挤压脐带
延迟断脐
早产儿
META分析
Umbilical Cord Milking
delayed cord clamping
premature infants
Meta-analysis
