抚触防治新生儿高胆血红素症的系统评价

Systematic evaluation of touch prevention and treatment of neonatal hyperbilirubinemia

目的系统评价抚触防治新生儿高胆血红素症的临床疗效,总结目前临床研究存在的问题及解决方法。方法计算机检索Cochrane图书馆、Pub Med、CBM、CNKI、VIP数据库、万方数据库(从建库至2018年6月)中关于抚触防治新生儿高胆血红素症的临床研究文献,由两名研究者独立提取资料,并根据Jadad改良法制定量表进行文献质量评价。采用Rev Man5. 3软件进行Meta分析。结果①高胆红素血症发生率[OR=0. 27,95%CI (0. 20,0. 36)],差异有统计学意义(P <0. 001)。②经皮测黄疸指数[MD=-2. 56,95%CI(-2. 81,-2. 31)],差异有统计学意义(P<0. 001)。结论抚触对新生儿高胆血红素症的发生率和降低经皮黄疸指数有效,为临床研究设计改进方法学质量问题,减低自身局限性提供更高质量的研究证据。

Objective To systematically evaluate the clinical effects of touch prevention and treatment of neonatal hyperbilirubinemia and to summarize the existing problems and solutions of current clinical research.Methods Literature about touch prevention and treatment of neonatal hyperbilirubinemia was searched from PubMed,Co-chrane Library,China National Knowledge Infrastructure Database,VIP Chinese Science and Technology Periodi-cal Database,Chinese Biomedical Literature Database and Wanfang Database(from the establishment of the library to June 2018).Two authors collected the data independently.Literature quality was evaluated according to the Jadad improved method.Then,the data were analyzed by Rev Man 5. 3 software for meta-analysis. Results There were significant differences in incidence of neonatal hyperbilirubinemia(OR = 0. 27,95% CI = 0. 20 ~ 0. 36,P<0. 001).There were significant differences in transcutaneous bilirubin level(MD =-2. 56,95% CI =-2. 81 ^-2. 31,P<0. 001).Conclusion Touch is effective for reduction of the incidence of neonatal hyperbilirubinemia and the reduction of percutaneous jaundice index.This provides the higher quality research evidence for improving the quality of methodology in clinical research design and reducing its own limitations.