| 摘要: |
| 目的 评价剖宫产术前应用碘伏进行阴道消毒预防术后感染的效果。 目的 利用计算机检索PubMed、EMBASE、中国生物医学文摘数据库(CBM)、中国知网期刊全文数据库(CNKI)、维普中文期刊全文数据库(CQVIP)中所有相关随机对照研究,按照标准对其筛选后进行质量评价,采用RevMan 5.2软件进行meta分析。 结果 纳入9个随机对照研究,共3 024例研究对象,其中术前阴道消毒产妇1 508例,对照组1 516例。分析结果表明,剖宫产术前应用碘伏进行阴道消毒能够降低术后子宫内膜炎发生率(RR=0.55, 95%CI 0.36~0.85,P=0.007),对胎膜早破产妇(RR=0.29, 95%CI 0.16~0.52,P<0.000 1)和临产产妇(RR=0.63, 95%CI 0.41~0.96,P=0.03)子宫内膜炎发生率降低作用显著,而对胎膜未破产妇(RR=0.73, 95%CI 0.50~1.08,P=0.11)和未临产产妇(RR=0.79, 95%CI 0.53~ 1.17,P=0.24)的降低作用不显著。阴道消毒并不能降低术后切口感染率(RR=0.80,95%CI 0.53~1.22,P=0.30)和术后发热发生率(RR=0.92,95%CI 0.76~1.11,P=0.37)。 结论 剖宫产术前给予阴道消毒能减少术后子宫内膜炎发生率,对胎膜早破产妇或临产产妇作用显著,但并不能降低术后切口感染率和发热率。 |
| 关键词: 剖宫产术 阴道消毒 术后感染 meta分析 |
| DOI：10.3724/SP.J.1008.2015.01080 |
| 投稿时间：2015-03-15修订日期：2015-07-08 |
| 基金项目: |
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| Vaginal disinfection before cesarean delivery in preventing postoperative infections: a meta-analysis |
| MENG Yi-chen1,WAN Qing2,HU Dian1* |
(1. Department of Obstetrics and Gynecology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China;
2. Medical Examination Center, Qingdao Second Sanatorium, PLA Jinan Military Area Command, Qingdao 266071, Shandong, China
*Corresponding author.) |
| Abstract: |
| Objective To analyze the efficacy of vaginal disinfection with povidone-iodine before cesarean delivery in preventing postoperative infections. Methods Randomized controlled trials, identified from a systematic search of relevant databases including PubMed, EMBASE, CBM, CNKI, and CQVIP, were screened and evaluated according to standardized criteria. RevMan 5.2 software was used to do the meta-analysis. Results A total of 9 randomized controlled trials with 3 024 participants, with 1 508 in the vaginal cleansing group and 1 516 in the control group, were included in this meta-analysis. The analysis result showed that vaginal disinfection with povidone-iodine before cesarean delivery reduced the incidence of post-cesarean endometritis (RR=0.55, 95%CI 0.36-0.85, P=0.007). The incidence of post-cesarean endometritis was significantly reduced in women with ruptured membranes (RR=0.29, 95%CI: 0.16-0.52, P<0.000 1) and women in labor (RR=0.63, 95%CI 0.41-0.96, P=0.03), but not significantly reduced in the women with intact membranes (RR=0.73, 95%CI 0.50-1.08, P=0.11) or women not in labor (RR=0.79, 95%CI 0.53-1.17, P=0.24). Vaginal disinfection could not help to reduce the incidence of postoperative wound infection (RR=0.80, 95%CI 0.53-1.22, P=0.30) or postoperative fever (RR=0.92, 95%CI 0.76-1.11, P=0.37). Conclusion Vaginal disinfection with povidone-iodine before cesarean delivery can decrease the risk of post-cesarean endometritis, especially for women undergoing cesarean delivery with ruptured membranes or in labor, but vaginal disinfection do not reduce the risk of postoperative wound infection or fever. |
| Key words: cesarean section vaginal disinfection postoperative infection meta-analysis |
