经腹羊膜腔灌注术对未足月胎膜早破临床疗效的Meta分析

Clinical effect of transabdominal amnioinfusion for preterm premature rupture of membrane: a Meta analysis

目的：评价经腹羊膜腔灌注术治疗未足月胎膜早破的临床意义。方法：通过检索Medline（Pubmed）、Embase、Web of Science、the Cochrane Library外文数据库和万方、中国知网、中国生物医学文献中文数据库,筛选出有关利用经腹羊膜腔灌注术治疗未足月胎膜早破的随机或类随机对照研究。采用Review manager 5.1.0统计软件对纳入的文献进行Meta分析。结果：最终符合纳入标准的文献4篇,共有105例在经腹羊膜腔灌注术组,100例在对照组。灌注组和对照组在分娩潜伏期相比差异有统计学意义（MD=15.51,95%CI：0.92~30.10,P〈0.05）,经腹羊膜腔灌注术能显著延长未足月胎膜早破患者的分娩潜伏期;灌注组和对照组在分娩孕周数、剖宫产率、绒毛膜羊膜炎发生率方面相比差异无统计学意义（P均〉0.05）。灌注组和对照组在胎儿窘迫发生率、新生儿体重方面相比差异有统计学意义（P均〈0.05）;而在围生儿死亡率、肺发育不全、早发败血症方面相比差异无统计学意义（P均〉0.05）。结论：经腹羊膜腔灌注术能有效延长未足月胎膜早破患者的分娩潜伏期,降低胎儿窘迫发生率,增加新生儿体重,对改善围生期母儿的预后有重要意义。

Objective： To evaluate the clinical significance of transabdominal amnioinfusion for preterm premature rupture of membrane（ PPROM）. Methods： MEDLINE（ PubMed）,Embase,Web of Science,the Cochrane Library Foreign Database,Wanfang Database,CNKI and Chinese Biomedical Literature Database were retrieved,the random case- control studies about treating PPROM with transabdominal amnioinfusion were screened; Review manager 5. 1. 0 software was used for Meta analysis of included studies. Results： Four studies were included with 105 patients in study group and 100 patients in control group. There was statistically significant difference in latent period between study group and control group（ MD = 15. 51,95% CI： 0. 92- 30. 10,P〈0. 05）. Transabdominal amnioinfusion for PPROM patients could significantly prolong the latent period of delivery. There was no statistically significant difference in week of delivery,cesarean section rate and incidence rate of chorioamnionitis between the two groups（ P〈0. 05）. There were statistically significant differences in the incidence rate of fetal distress and neonatal weight between the two groups（ P〈0. 05）; but there was no statistically significant difference in perinatal mortality,incidence rates of pulmonary hypoplasia and early neonatal sepsis between the two groups（ P〈0. 05）.Conclusion： Transabdominal amnioinfusion for PPROM patients can prolong the latent period of delivery,reduce the incidence rate of fetal distress,increase neonatal weight and it has important significance for improving maternal and neonatal prognosis during perinatal period.