中央性前置胎盘孕妇治疗期间综合护理干预效果的Meta分析

The effect of comprehensive nursing intervention on pregnant women with central placenta previa during treatment:Meta-analysis

目的运用Meta分析方法评价早期综合护理干预在中央性前置胎盘治疗期间中的应用效果。方法检索PubMed、CNKI、万方、维普等数据库所有探讨早期综合护理干预在中央性前置胎盘治疗期间应用的文献,检索年限从建库至2018年6月。按照纳入和排除标准纳入相关的随机对照试验(RCT)或类实验性研究提取资料。将筛选出的文献按照CochraneReviewHandbook5.1.0质量评价标准进行质量评价。质量评价后运用RevMan5.3软件进行分析。结果最初检索到文献290篇,最后纳入3篇。Meta分析结果表明早期综合护理干预对中央性前置胎盘孕妇产前平均出血量[MD=4.00,95%CI(-19.54,27.54),P=0.74]无影响,但可降低中央性前置胎盘产妇产后平均出血量[MD=-245.81,95%CI(-395.33,-96.30),P=0.001];降低产妇产褥期感染的发生率[RR=0.20,95%CI(0.05,0.79),P=0.02];增加新生儿的体重[MD=0.58,95%CI(0.41,0.75),P<0.0001]和新生儿Apgar评分[MD=0.90,95%CI(0.73,1.07),P<0.0001]。结论早期综合护理干预可降低产妇产褥期感染的发生率,增加中央性前置胎盘新生儿的体重和新生儿Apgar评分;然而要利用Seldinger技术进行双侧子宫动脉栓塞的介入治疗并做好相应的护理措施,才可有效降低产前以及产后出血量。

Objective To determine the effect of early comprehensive nursing intervention in the treatment of central placenta previa by using Meta-analysis method. Methods Pubmed,CNKI,Wanfang and Weipu databases were retrieved to explore the application of early comprehensive nursing intervention in the treatment of central placenta previa.The retrieval period was from the establishment of the database to June 2018.Quality evaluation,data extraction and data analysis were conducted after inclusion and exclusion criteria were included in relevant randomized controlled trials (RCTs) or similar experimental studies. Results 290 literatures were initially retrieved and 3 were included.The results of Meta-analysis showed that early comprehensive nursing intervention had no effect on the average prenatal bleeding of pregnant women with central placenta previa [RR = 4.00,95% CI (-19.54,27.54)],but it could reduce the average postpartum bleeding of pregnant women [MD=-245.81,95% CI (-395.33,-96.30)],reduce the incidence of puerperal infection [RR = 0.20,95% CI (0.05,0.79)] and increase the weight of newborns [MD= 0.58,95% CI (0.41,0.75)] and newborn Apgar scores [MD = 0.90,95% CI (0.73,1.07)]. Conclusion Early comprehensive nursing intervention can reduce the incidence of puerperal infection in pregnant women with central placenta previa,increase the weight of newborns and the Apgar scores of newborns,but only by using Seldinger technique for interventional treatment of bilateral uterine artery embolism and proper nursing can the prenatal and postpartum maternal bleeding be effectively reduced.