葡萄糖酸钙联合米索前列醇防治产后出血的疗效分析

Therapeutic Effect Analysis of Calcium Gluconate Combined With Misoprostol for Postpartum Hemorrhage

目的对葡萄糖酸钙联合米索前列醇防治产后出血的疗效以及安全性进行系统评价。方法全面检索网上数据库,纳入葡萄糖酸钙联合米索前列醇vs.米索前列醇用于产后出血治疗的所有随机对照试验(RCTs),进行Meta分析。结果共纳入16个RCT,包括4 041例患者。Meta分析结果显示,与米索前列醇相比,米索前列醇联合葡萄糖酸钙显著减少术中出血量[MD=-65.40,95%CI(-94.74,-36.06),P<0.000 1]、产后2 h出血量[MD=-61.36,95%CI(-73.16,-49.56),P<0.000 01]、产后24 h出血量[MD=-81.79,95%CI(-99.05,-64.54),P<0.000 01]及产后出血发生率[RR=0.29,95%CI(0.20,0.41),P<0.000 01],而第三产程时间[MD=-2.15,95%CI(-5.81,1.50),P=0.25]没有统计学差异。结论与使用米索前列醇相比,米索前列醇联合葡萄糖酸钙能减少产后出血量。

Objective To systematically evaluate the efficacy and safety of calcium gluconate combined with misoprostol vs. misoprostol for postpartum hemorrhage（PPH）.Methods Retrieved from databases online, randomized controlled trials （RCTs） of calcium gluconate combined with misoprostol vs. misoprostol for PPH were retrieved and analyzed.Results 16 RCTs involving 4 041 patients. The results of meta-analysis showed that： compared with misoprostol, calcium gluconate combined with misoprostol could decrease the operative blood loss [MD=-65.40, 95% CI （-94.74, -36.06） ,P〈0.000 1], the bleeding of 2 hours after delivery[MD=-61.36, 95%CI （-73.16, -49.56） ,P〈0.000 01], the bleeding of 24 hours after delivery[MD=-81.79, 95%CI（-99.05, -64.54） ,P〈0.000 01], and the rate＆amp;nbsp;of PPH[RR=0.29, 95%CI （0.20, 0.41） ,P〈0.000 01], while for the third labor time were [MD=-2.15, 95%CI （-5.81, 1.50）,P=0.25], there were no significant differences between two groups.Conclusion Compared with misoprostol, calcium gluconate combined with misoprostol make a better effect on preventing PPH.