椎管内分娩镇痛对剖宫产术后再次妊娠阴道试产母婴结局影响的Meta分析

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Abstract Objective：To systematically evaluate the effect of intraspinal delivery analgesia on the outcomes of pregnant women and infants undergoing vaginal trial delivery after cesarean section.Methods：PubMed，Web of Science，EMbase，the Cochrane Library，CNKI，CBM，VIP，WanFang base Database and other databases were searched by computer from the inception of the databases to April 5，2022，to find out the randomized controlled studies on intraspinal delivery analgesia and vaginal trial of pregnancy after cesarean section.Two researchers independently selected and screened the literature according to the inclusion and exclusion criteria.RevMan 5.4 software was used for statistical analysis of the selected literature.Results：Finally，12 clinical studies were included，all of which were randomized controlled trials.Meta-analysis results showed that there were statistically significant differences in the success rate［OR=2.94，95%CI（2.21，3.93），P<0.000 01］ and the use of oxytocin［OR=3.42，95%CI（2.01，5.81），P<0.000 1］ of vaginal trial labor after cesarean section.There was no significant difference in the incidence of fetal distress［OR=0.70，95%CI（0.42，1.16），P=0.16］，uterine rupture rate［OR=0.89，95%CI（0.25，3.13），P=0.86］，and postpartum hemorrhage rate［OR=1.19，95%CI（0.74，1.90），P=0.47］.Conclusion：Current evidence shows that the use of intraspinal delivery analgesia for vaginal trial delivery after cesarean section can improve the rate of vaginal trial delivery，do not mask the occurrence of uterine rupture and fetal distress，do not increase postpartum bleeding，and have a good maternal and infant outcome.

Keywords intraspinal delivery analgesia;vaginal trial labor;vaginal delivery;maternal and infant outcomes;Meta-analysis

作者简介 王玥，护士，硕士研究生在读

*通讯作者 丁晓华，E-mail：479259916@qq.com

引用信息 王玥，丁晓华，马子怡，等.椎管内分娩镇痛对剖宫产术后再次妊娠阴道试产母婴结局影响的Meta分析［J］.循证护理，2023，9（8）：1359-1363.

摘要 目的：系统评价椎管内分娩镇痛对剖宫产术后再次妊娠阴道试产母婴结局的影响。（剩余7558字）