无保护会阴分娩技术用于初产妇会阴分娩效果的Meta分析

Effects of “hands off” techniques on primipara:a meta-analysis

目的系统性评价无保护会阴分娩技术用于初产妇会阴分娩的效果。方法利用计算机检索中国期刊全文数据库(CNKI)、万方数据知识服务平台、中国维普全文数据库(VIP)、Cochrane图书馆、Web of Science、Pub Med和EMBASE中关于无保护会阴分娩技术与传统会阴分娩技术的随机对照试验,由2名评价者独立评价并交叉核对纳入研究质量,按照CochraneHandbook 5.1.0手册的质量评价方法评价纳入研究质量,并筛选纳入文献的参考文献,由RenMan 5.3软件进行统计处理。结果共纳入12篇随机对照试验,Meta分析结果证实,无保护会阴分娩可以降低产妇会阴侧切(Z=5.70,P<0.01)、不增加会阴裂伤、不增加新生儿窒息(Z=2.72,P<0.01)和缩短第二产程时间(Z=3.86,P<0.01)。结论无保护会阴分娩技术可以降低会阴侧切、缩短第二产程时间、不增加会阴裂伤和新生儿窒息,值得临床推广。

Objective To assess the effects of ＂hands off＂ techniques on primipara. Methods A computerized search in CNKI,VIP data,Wanfang data,Cochrane library,Web of Science,PubMed and EMBASE was performed for relevant randomized controlled trials（RCTs） which compared the effectiveness of two techniques during spontaneous delivery. The quality of studies was critically appraised and data were extracted by two reviewers independently. The Cochrane Handbook 5.1.0 was used to evaluate the quality of studies. Data were analyzed by RevMan 5.3 version. Results Twelve RCTs were involved,and meta-analysis showed that the ＂hands off＂ techniques could reduce the episiotomy（Z=21.49,P〈0.01）,not increase perineal tears and asphyxia（Z=2.72,P〈0.01） and shorten duration of 2nd stage（Z=3.86,P〈0.01）. Conclusion The ＂hands off＂ techniques can reduce the episiotomy,not increase perineal tears and asphyxia,and it can shorten duration of 2nd stage,which is worth being popularized.