摘要
目的通过系统评价Meta分析的方法对卡前列甲酯(卡孕栓)在预防和治疗产后出血、促进产后排气及治疗尿潴留的效果进行研究。方法计算机检索中国生物医学文献光盘数据库、中国学术期刊全文数据库、中文科技期刊数据库、中文生物医学期刊文献数据库等电子数据库,查找卡孕栓预防或治疗产科疾病的随机对照试验和临床对照试验。由两位评价员独立进行资料提取后,采用Stata软件进行Meta分析。结果共纳入卡孕栓预防产后出血文献23篇,治疗产后出血8篇,治疗产后排气3篇,治疗尿潴留3篇。23项研究(共25个数据集)显示卡孕栓预防产后出血的效果优于缩宫素,可使术后2h出血量减少69.25mL、24h出血量减少93.01mL、第三产程时间缩短3.52min,对应均数差及95%可信区间分别为-69.25(-81.31,-57.20)、-93.01(-106.82,-79.19)、和-3.52(-4.12,-2.92)(P<0.05)。在产后出血的治疗中,卡孕栓优于缩宫素,卡孕栓可将术后2、24h出血量分别减少71.46mL(P<0.001)、73.37mL(P=0.035),缩短第三产程时间2.94min(P<0.05),差异均有统计学意义。结论卡孕栓对预防和治疗产后出血及促进产后排气方面均有显著效果,但尚需更多高质量的随机对照试验来进一步验证。
Objective To systematically assess the effect of Carboprost Suppositories in prevention and treatment of postpartum hemorrhage, postpartum exhaust and urine retention. Methods Randomized controlled trials and clinical controlled trials of Carboprost Suppositories in prevention and treatment of obstetrical diseases were searched in Chinese Biomedical Literature Database, China National Knowledge Infrastructure, et al. The quality of the included studies was evaluated and the data were extracted by two assessors independently. Meta-analyses were performed with Stata software. Results 23 studies on preventing postpartum hemorrhage, 8 studies on treatment of postpartum hemorrhage ,3 studies on treatment of postpartum exhaust and 3 studies on treatment of urine retention were identified. The Meta-analyses on preventing postpartum hemorrhage showed that Carboprost Suppositories statistically decrease the amount of 2-hour hemorrhage, 24-hour hemorrhage and shorten the time of third stage of labor and the corresponding mean difference and 95% CI were -69.25（ -81.31,-57.20）,-93.01（-106.82,-79.19） and -3.52（ -4.12,-2.92）（P〈0.05）.TheMeta-analyses on treating postpartum hemorrhage indicated that Carboprost Suppositories could decrease the amount of 2-hour hemorrhage （ 71.46 mL） and 24-hour hemorrhage （ 73.37 mL ）, and shorten the time of third stage of labor （ 2.94 min）. Carboprost Suppositories could shorten the time of postpartum exhaust about 16. 48 hours. All of these results were statistically significant. However there is no statistically significance in the treatment of urine retention （ RR 1.67,95% CI 0. 62 - 1.56）. Conclusion The present meta-analysis convinced that Carboprost Suppositories plays significant role in prevention and treatment of postpartum hemorrhage and shorten the time of postpartum exhaust. Yet, more and higher level randomized controlled trials are also needed to further confirm the conclusion.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2013年第6期486-492,共7页
Chinese Journal of Practical Gynecology and Obstetrics
关键词
卡孕栓
产后出血
系统评价
META分析
carboprost suppositories
postpartum hemorrhage
systematic review
Meta-analysis
