剖宫产术前阴道消毒对预防术后感染效果的meta分析被引量：5

Vaginal disinfection before cesarean delivery in preventing postoperative infections:a meta-analysis

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摘要目的评价剖宫产术前应用碘伏进行阴道消毒预防术后感染的效果。方法利用计算机检索PubMed、EMBASE、中国生物医学文摘数据库（CBM）、中国知网期刊全文数据库（CNKI）、维普中文期刊全文数据库（CQVIP）中所有相关随机对照研究,按照标准对其筛选后进行质量评价,采用RevMan 5.2软件进行meta分析。结果纳入9个随机对照研究,共3 024例研究对象,其中术前阴道消毒产妇1 508例,对照组1 516例。分析结果表明,剖宫产术前应用碘伏进行阴道消毒能够降低术后子宫内膜炎发生率（RR=0.55,95%CI 0.36~0.85,P=0.007）,对胎膜早破产妇（RR=0.29,95%CI 0.16~0.52,P〈0.000 1）和临产产妇（RR=0.63,95%CI 0.41~0.96,P=0.03）子宫内膜炎发生率降低作用显著,而对胎膜未破产妇（RR=0.73,95%CI 0.50~1.08,P=0.11）和未临产产妇（RR=0.79,95%CI 0.53~1.17,P=0.24）的降低作用不显著。阴道消毒并不能降低术后切口感染率（RR=0.80,95%CI 0.53~1.22,P=0.30）和术后发热发生率（RR=0.92,95%CI0.76~1.11,P=0.37）。结论剖宫产术前给予阴道消毒能减少术后子宫内膜炎发生率,对胎膜早破产妇或临产产妇作用显著,但并不能降低术后切口感染率和发热率。 Objective To analyze the efficacy of vaginal disinfection with povidone-iodine before cesarean delivery in preventing postoperative infections.Methods Randomized controlled trials,identified from a systematic search of relevant databases including PubMed,EMBASE,CBM,CNKI,and CQVIP,were screened and evaluated according to standardized criteria.RevMan 5.2software was used to do the meta-analysis.Results A total of 9randomized controlled trials with 3 024 participants,with 1 508 in the vaginal cleansing group and 1 516 in the control group,were included in this meta-analysis.The analysis result showed that vaginal disinfection with povidone-iodine before cesarean delivery reduced the incidence of postcesarean endometritis（RR=0.55,95% CI 0.36-0.85,P =0.007）.The incidence of post-cesarean endometritis was significantly reduced in women with ruptured membranes（RR=0.29,95%CI：0.16-0.52,P〈0.000 1）and women in labor（RR=0.63,95%CI 0.41-0.96,P=0.03）,but not significantly reduced in the women with intact membranes（RR=0.73,95%CI 0.50-1.08,P=0.11）or women not in labor（RR=0.79,95%CI 0.53-1.17,P=0.24）.Vaginal disinfection could not help to reduce the incidence of postoperative wound infection（RR=0.80,95%CI 0.53-1.22,P=0.30）or postoperative fever（RR=0.92,95%CI 0.76-1.11,P=0.37）.Conclusion Vaginal disinfection with povidone-iodine before cesarean delivery can decrease the risk of post-cesarean endometritis,especially for women undergoing cesarean delivery with ruptured membranes or in labor,but vaginal disinfection do not reduce the risk of postoperative wound infection or fever.

作者孟怡辰万青胡电

机构地区第二军医大学长征医院妇产科济南军区青岛第二疗养院体检中心

出处《第二军医大学学报》 CAS CSCD 北大核心 2015年第10期1080-1086,共7页 Academic Journal of Second Military Medical University

关键词剖宫产术阴道消毒术后感染 META分析 cesarean section vaginal disinfection postoperative infection meta-analysis

分类号 R719.8 [医药卫生—妇产科学]

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