[1]唐英,樊薇,张志刚,等.子宫按摩及按摩时机对产后出血影响的Meta分析[J].西部中医药,2021,34(06):58-64.[doi:10.12174/j.issn.2096-9600.2021.06.15]
　TANG Ying,FAN Wei,ZHANG Zhigang,et al.Meta analysis of the Effects of Uterine Massage and Massage Phase on Postpartum Hemorrhage[J].Western Journal of Traditional Chinese Medicine,2021,34(06):58-64.[doi:10.12174/j.issn.2096-9600.2021.06.15]
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子宫按摩及按摩时机对产后出血影响的Meta分析
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《西部中医药》[ISSN:2096-9600/CN:62-1204/R]

卷:
34
期数:
2021年06期
页码:
58-64
栏目:
出版日期:
2021-06-15

文章信息/Info

Title:
Meta analysis of the Effects of Uterine Massage and Massage Phase on Postpartum Hemorrhage
作者:
唐英1, 樊薇2, 张志刚3, 张彩云3, 田金徽4, 张永红5
1.四川大学华西第二医院生殖医学科护理单元/四川大学华西护理学院/出生缺陷与相关妇儿疾病教育部 重点实验室,四川 成都 610041
2.甘肃省妇幼保健院
3.兰州大学第一医院
4.兰州大学循证医学中心
5.宝鸡市中心医院
Author(s):
TANG Ying1, FAN Wei2, ZHANG Zhigang3, ZHANG Caiyun3, TIAN Jinhui4, ZHANG Yonghong5
1.Key Laboratory of the Ministry of Education of Birth Defects and Related Maternal and Child Diseases, Nursing Unit of Reproductive Medicine Department, West China Second University Hospital, Sichuan University/West China Nursing School, Sichuan University, Chengdu 610066, China
2.Gansu Provincial Maternity and Child-care Hospital
3.The First Hospital of Lanzhou University
4.Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University
5.Baoji City Central Hospital
关键词:
子宫按摩; 按摩时机; 自然分娩; 产后出血量; Meta分析
Keywords:
uterine massage; massage phase; natural labor; postpartum hemorrhage amount; Meta-analysis
分类号:
R271.4
DOI:
10.12174/j.issn.2096-9600.2021.06.15
摘要:
目的对产后子宫按摩及按摩时机减少产妇出血量的有效性进行系统评价。 方法计算机检索中国知识基础设施数据库（1997年9月至2016年9月）、中国生物医学文献数据库（1997年9月至2016年9月），万方数据库（1997年9月至2016年9月），public medicine（PubMed）（1996年9月至2016年9月），荷兰医学文摘（1996年9月至2016年9月），cochrane library（1997年9月至2016年10月）。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后，采用RevMan 5.0软件进行Meta分析。 结果共纳入9个研究，4226例患者。Meta分析结果显示：与胎儿娩出后肌注缩宫素相比，子宫按摩结合肌注缩宫素在降低产后出血发生率［OR=0.26，95%CI（0.10，0.67），P＜0.05］和产后2 h出血量［OR=-1.58，95%CI（-2.77，-0.38）、P＜0.05］、第三产程出血量［OR=-0.75，95%CI（-0.89，-0.60），P＜0.05］、产后24 h出血量［OR=-2.10，95%CI（-3.23，-1.84），P＜0.05］等方面，差异有统计学意义。对胎盘娩出前后进行按摩亚组分析显示：子宫按摩在胎盘娩出前后均能降低产后出血量，差异具有统计学意义（P＜0.05）。 结论现有证据表明，产后给予产妇常规肌注缩宫素的同时结合子宫按摩能有效减少产妇产后的出血量，在胎盘娩出前后实施子宫按摩均能减少产后出血量。受纳入研究数量和文献质量限制，对按摩具体时长及缩宫素的用量尚需开展更多高质量研究予以验证。
Abstract:
ObjectiveTo systematically assess the effectiveness of postpartum uterine massage and massage phase in reducing maternal bleeding. MethodsAfter searching CNKI (September 1997 to September 2016), CBM (September 1997 to September 2016), Wanfang database (September 1997 to September 2016), PubMed (September 1996 to September 2016), Embase (September 1996 to September 2016) and cochrane library (September 1997 to October 2016) using computer, two reviewers independently screened the literature, extracted data and evaluated the risk of bias in the included studies. RevMan 5.0 software was used for Meta-analysis. ResultsAll nine studies and 4226 patients were included. Meta-analysis results showed: compared with intramuscular injection of oxytocin after delivery, uterine massage and intramuscular injection of oxytocin could reduce the incidence of postpartum hemorrhage [OR=0.26, 95%CI(0.10,0.67), P<0.05], the amount of hemorrhage two hours after delivery [OR=-1.58, 95%CI(-2.77, -0.38), P<0.05], blood loss in the third stage of labor [OR=-0.75, 95%CI(-0.89, -0.60), P<0.05], the difference had statistical meaning in the amount of hemorrhage 24 hours after delivery [OR=-2.10, 95%CI(-3.23, -1.84), P<0.05]. Massage subgroup analysis before and after the delivery of the placenta showed that uterine massage could decrease the amount of postpartum hemorrhage before and after the delivery of the placenta, and the difference had statistical meaning(P<0.05). ConclusionCurrent evidence presented that uterine massage could effectively reduce the amount of postpartum hemorrhage on the foundation of intramuscular injection of oxytocin, the implementation before and after the delivery of the placenta could reduce the amount of postpartum hemorrhage. Limited by the number and quality of included studies, more high-quality studies are needed to verify the specific duration of massage and the dosage of oxytocin.

备注/Memo

备注/Memo:
唐英（1991—），女，硕士学位，护师。研究方向：临床护理。
更新日期/Last Update: 2021-06-15