首页|药物干预分娩镇痛产时发热的Meta分析

药物干预分娩镇痛产时发热的Meta分析

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目的 系统评价糖皮质激素、对乙酰氨基酚及抗菌药物应用于分娩镇痛产时发热的临床疗效及安全性.方法 计算机检索 PubMed、Embase、Cochrane Library、Web of Science、CBM、VIP 和 CNKI 数据库,搜集糖皮质激素、对乙酰氨基酚及抗菌药物应用于分娩镇痛产时发热的随机对照试验(randomized controlled trial,RCT),检索时限均从建库至2023年6月30日.由2位评价员独立筛选文献、提取资料并评价纳人文献的偏倚风险后,采用RevMan 5.4软件进行Meta分析.结果 共纳入10个RCT,包括1 337名产妇.Meta分析结果显示:与对照组相比,应用糖皮质激素可降低分娩镇痛产妇产时发热发生率[OR=0.52,95%CI(0.33,0.82),P<0.01],但使用对乙酰氨基酚和抗菌药物与对照组的差异无统计学意义.结论 当前证据显示,应用糖皮质激素可降低分娩镇痛产妇产时发热发生率,但使用对乙酰氨基酚及抗菌药物未能降低产妇产时发热的发生率.受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证.
Pharmacological interventions for intrapartum fever in labor analgesia:a meta-analysis
Objective To systematically review the clinical efficacy and safety of glucocorticoids,acetaminophen and antimicrobial drugs in the treatment of intrapartum fever in labor analgesia.Methods The PubMed,Embase,Cochrane Library,Web of Science,CBM,VIP,and CNKI databases were electronically searched to collect randomized controlled trials(RCTs)of glucocorticoids,acetaminophen,and antimicrobial drugs for intrapartum fever in labor analgesia from inception to June 30,2023.Two reviewers independently screened the literature,extracted data,and evaluated the risk of bias of the included literature.Meta-analysis was then performed by using RevMan 5.4 software.Results A total of 10 RCTs involving 1 337 women were included.Meta-analysis showed that the use of glucocorticoids reduced the incidence of intrapartum fever in women with labor analgesia compared with the control group(OR=0.52,95%CI 0.33 to 0.82,P<0.01).But there was no statistically significant difference between acetaminophen or antimicrobial drugs and the control group.Conclusion Current evidence shows that the use of glucocorticoids can reduce the incidence of intrapartum fever in labor analgesia,but the use of acetaminophen and antimicrobial drugs cannot reduce the incidence of intrapartum fever.Due to the limited quality and quantity of the included studies,more high quality studies are needed to verify the above conclusion.

Labor analgesiaIntrapartum feverCorticosteroidsAcetaminophenAntibioticsMeta-analysisRandomized controlled trial

李梦洲、刘月、唐昱英

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四川大学华西第二医院麻醉科(成都 610041)

四川泰康医院麻醉科(成都 610200)

分娩镇痛 产时发热 糖皮质激素 对乙酰氨基酚 抗菌药物 Meta分析 随机对照试验

成都市科技项目

2022-YF05-01261-SN

2024

中国循证医学杂志
四川大学

中国循证医学杂志

CSTPCD北大核心
影响因子:1.761
ISSN:1672-2531
年,卷(期):2024.24(7)
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