摘要
目的系统评价连续性助产护理对产妇分娩效果的影响。方法计算机检索万方、中国知网(CNKI)、维普、PubMed、Embase、Cochrane Library及Web of Science等数据库中关于连续性助产护理对产妇分娩效果影响的随机对照试验(RCT)。由2名研究生独立使用Cochrane协作网关于干预性研究系统评价手册5.1版对纳入的文献进行方法学的质量评价后,使用Revman 5.4软件进行Meta分析。结果最终纳入16篇RCT研究,总样本量为6573例。Meta分析结果显示:实施连续性助产护理后,实验组产妇自然分娩率高于对照组[RR=1.23,P<0.0001,95%CI(1.19,1.28)];第一产程短于对照组[SMD=-1.73,P=0.02,95%CI(-3.15,-0.32)];产后2 h出血率低于对照组[RR=0.49,P=0.0007,95%CI(0.32,0.74)];待产时焦虑情绪[MD=-2.77,P<0.00001,95%CI(-3.81,-1.73)]和产后24 h焦虑情绪[SMD=-0.58,P<0.00001,95%CI(-0.77,-0.39)]优于对照组,对护理人员满意度高于对照组[RR=1.18,P<0.00001,95%CI(1.13,1.22)]。在新生儿窒息率方面,差异无统计学意义[RR=0.66,P=0.07,95%CI(0.43,1.03)]。结论连续性助产护理可有效地提升产妇自然分娩率,缩短第一产程时间,减少产后2 h出血率,改善焦虑情绪,提升护理满意度,但在改善新生儿窒息率方面,仍需高质量的研究进行论证。
Objective To systematically evaluate the effect of continuous midwifery care on maternal delivery by using Meta-analysis.Methods Randomized controlled trials(RCT)on the effect of continuous midwifery care on maternal delivery in the databases of WanFang,CNKI,VIP,PubMed,Embase,Cochrane Library,and Web of Science were retrieved by computer.Two postgraduate students independently used the Cochrane Collaborative Network's Manual on Systematic Evaluation of Interventional Studies,version 5.1,to evaluate the methodological quality of the included literature,and Meta-analysis was finally used to analyze the data extracted from the included literature by the Revman5.4 statistical software.Results Totally 16 RCTs involving 6573 samples were included.Meta-analysis showed that after the implementation of continuous midwifery care,the natural delivery rate in the intervention group was higher than that in the control group(RR=1.23,P<0.0001;95%CI was from 1.19 to 1.28),the first stage of labor time was shorter than that in the control group(SMD=-1.73,P=0.02;95%CI was from-3.15 to-0.32),and the postpartum 2 h bleeding rate was less than that of the control group(RR=0.49,P=0.0007;95%CI was from 0.32 to 0.74),anxiety in waiting for delivery(MD=-2.77,P<0.00001;95%CI was from-3.81 to-1.73)and postpartum anxiety at 24 h(SMD=-0.58,P<0.00001;95%CI was from-0.77 to-0.39)outperform the control group,and satisfaction with caregivers was higher than that of the control group(RR=1.18,P<0.00001;95%CI was from 1.13 to 1.22);in terms of neonatal asphyxia rate(RR=0.66,P=0.07;95%CI was from 0.43 to 1.03),the difference between two groups was not statistically significant.Conclusion Continuous midwifery care can effectively increase the rate of natural childbirth,shorten the first stage of labor,reduce the postpartum 2 h bleeding rate,improve anxiety,and increase nursing satisfaction,but high-quality studies are still needed to confirm the analysis in improving neonatal asphyxia rates.
作者
路诗雨
叶红芳
汪茂莎
LU Shiyu;YE Hongfang;WANG Maosha(Department of Nursing,Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School,Nanjing 210008,JiangSu,China)
出处
《护士进修杂志》
2022年第16期1492-1497,共6页
Journal of Nurses Training
