剖宫产术后早期离床活动干预效果的系统评价

A systematic review of the intervention effect of early mobilization after cesarean section

目的评价早期离床活动对剖宫产产妇干预效果的影响。方法检索Cochrane Library、PubMed、Web of Science、SinoMed、知网、万方、维普数据库,从建库至2022年1月关于剖宫产术后早期离床活动及其对产妇干预效果影响的相关文献,并采用RevMan 5.3软件进行分析。结果共纳入8项研究,1384名产妇。meta分析结果显示,实验组剖宫产术后并发症的发生率(RR=0.16,95%CI:0.06~0.41,P=0.0002)和术后24 h阴道出血量(MD=-33.80,95%CI:-47.27~-20.33,P<0.00001)均低于对照组;首次肛门排气时间(MD=-6.35,95%CI:-8.09~-4.61,P<0.00001)和初次泌乳时间(MD=-6.59,95%CI:-11.91~-1.28,P=0.02)均短于对照组,而在术后住院时间方面差异无统计学意义(SMD=-0.49,95%CI:-1.05~0.08,P=0.09)。结论早期离床活动可促进术后恢复,有效缩短剖宫产产妇术后首次肛门排气时间和初次泌乳时间,减少术后并发症及24 h阴道出血量,可在临床进一步推广应用。

Objective To evaluate the influence of early mobilization on the intervention effect after cesarean section.Methods Relevant literature on the effect of early mobilization after cesarean section were searched in Web of Science,PubMed,Cochrane Library,CNKI,Wanfang,VIP and biomedical literature databases from the establishment of the database to January 2022,RevMan 5.3 software was used for meta-analysis.Results A total of 8 studies with 1384 puerpera were included.The results of meta-analysis showed that the incidence of complications after cesarean section in the experimental group(RR=0.16,95%CI[0.06,0.41],P=0.0002),and the amount of vaginal bleeding at 24 hours after surgery(MD=-33.80,95%CI[-47.27,-20.33],P<0.00001)were lower than those in the control group.The first anal exhaust time(MD=-6.35,95%CI[-8.09,-4.61],P<0.00001)and the first lactation time(MD=-6.59,95%CI[-11.91,-1.28],P=0.02)were shorter than those in the control group.However,there was no significant difference in hospital stay(SMD=-0.49,95%CI[-1.05,0.08],P=0.09)between the two groups.Conclusion Early mobilization can promote postoperative recovery,effectively shorten the time of the first anal exhaust and lactation after ces arean section,reduce postoperative complications and 24 hours vaginal bleeding after surgery,which can be further popularized and applied in clinical practice.