瘢痕子宫再次剖宫产并发前置胎盘Meta分析.docxVIP

瘢痕子宫再次剖宫产并发前置胎盘Meta分析 　　[摘要] 目的 采用Meta分析方法对国内有关瘢痕子宫再次剖宫产时的并发前置胎盘的相关文献进行综合分析，从而降低剖宫产率。方法 通过计算机文献检索收集XX―XX年国内有关瘢痕子宫与非瘢痕子宫剖宫产并发症的对比分析，采用Rev 分析软件。首先进行异质性检验，当结果不存在异质性时，以固定效应模型描述，存在异质性时，以随机效应模式表达，将资料进行定量综合。采用比值比及其95%可信区间表示。结果 严格按照纳入标准及排除标准，最终符合标准的病例对照研究的文献16篇，其中挑选获得有关前置胎盘的文献13篇。前置胎盘合并OR值及95%可信区间分别是OR=，95%CI。结论 瘢痕子宫再次剖宫产并发前置胎盘发生率明显高于非瘢痕子宫。　　[关键词] 瘢痕子宫；并发症；前置胎盘；Meta分析　　[中图分类号] R4 [文献标识码] A [文章编号] 1674--0053-05　　[Abstract] Objective To comprehensively analyze the scarred uterus with secondary cesarean section combined with placenta previa by the Meta analysis to reducing the cesarean section rate. Methods The complications of scarred uterus with cesarean section and non- scarred uterus with cesarean section at home from XX to XX were retrieved and collected by the computer for comparison and analysis， and analyzed by the Rev software， and they were for heterogeneity test firstly， if the results had no heterogeneity， the fixed effect model was used for description， if the results had heterogeneity， the random effect model was used for expression， and the data were for quantitative synthesis， and expressed by OR and 95%CI. Results There were 16 literatures finally met the standards according to the inclusion and exclusion standards， and 13 literatures related to placenta previa were selected， and the OR=， 95%CI . Conclusion The incidence rate of scarred uterus with secondary cesarean section combined with placenta previa is obviously higher than that of non- scarred uterus.　　[Key words] Scarred uterus； Complication； Placenta previa； Meta analysis　　近年?恚?由于各种原因剖宫产率导致剖宫产率居高不下，虽然剖宫产是解决难产及解除母婴危险状态的一种有效方法，但随之而来的手术并发症问题也客观存在着，特别是给瘢痕子宫再次妊娠的孕妇带来了许多棘手的问题，如盆腔粘连，子宫破裂，产后出血，前置胎盘等。瘢痕子宫再次妊娠分娩大多数选择了再次剖宫产，有研究表明瘢痕子宫剖宫产手术风险远高于非瘢痕子宫[1]。近年来国内对瘢痕子宫再次剖宫产手术并发症的研究文献较多，XX―XX年该文拟对并发症的中前置胎盘行综合分析来比较瘢痕子宫和非瘢痕子宫手术风险，从而降低由瘢痕子宫造成的并发症，现报道如下。　　1 资料与方法　　 一般资料　　资料来源于计算机检索万方、CNKI搜集国内有关瘢痕子宫再次剖宫产时的并发症的相关文献，同时通过文献追溯法查找符合要求的研究。中文检索瘢痕子宫、剖宫产、并发症。　　 统计方法　　采用Cochrane协作网提供的Rev 软件　　2 结果　　按检索策略共检索篇文献，最终选入此次Meta分析